Fetal scapular length as a gestational age predictor

Longitud de la escápula fetal en la predicción de la edad gestacional

Introduction: Accurate estimation of gestational age is critical to the successful clinical management of pregnant women. Fetal scapula length appears to correlate strongly with gestational age and may be useful in predicting gestational age in cases where other ultrasound measurements cannot be determined. Objective: To establish the usefulness of fetal scapula length measurement for the prediction of gestational age. Materials and methods: A prospective and longitudinal study was carried out in women with single pregnancies between 16 and 40 weeks who attended the Central Hospital "Dr. Urquinaona", Maracaibo, Venezuela. Biparietal diameter, abdominal circumference, femur length, and fetal scapula length were measured during the duration of pregnancy. Results: Data from 215 pregnant women was selected. A total of 3,289 total assessments were performed. Fetal scapula length showed strong, positive, and significant correlations with gestational age by date of last menstrual period and ultrasound values assessed (p < 0.001). The model of gestational age predicted by scapula length reached a coefficient of determination (r2) value of 0.908. The correlation between gestational age by date of last menstrual period and that predicted by the model using scapula length reached r = 0.953 (p < 0.001). Conclusion: Measurement of fetal scapula length is useful in predicting gestational age.

1. Poojari Y, Annapureddy PR, Vijayan S, Kalidoss VK, Mf Y, Pk S. A comparative study on third trimester fetal biometric parameters with maternal age. PeerJ. 2023;11:e14528. doi: 10.7717/peerj.14528.
2. Jain S, Acharya N. Fetal wellbeing monitoring: A review article. Cureus. 2022;14(9):e29039. doi: 10.7759/cureus.29039.
3. Petersen JM, Mitchell AA, Van Bennekom C, Werler MM. Validity of maternal recall of gestational age and weight at birth: Comparison of structured interview and medical records. Pharmacoepidemiol Drug Saf. 2019;28(2):269-273. doi: 10.1002/pds.4699.
4. Shi Y, Xue Y, Chen C, Lin K, Zhou Z. Association of gestational age with MRI-based biometrics of brain development in fetuses. BMC Med Imaging. 2020;20(1):125. doi: 10.1186/s12880-020-00525-9.
5. Zhao J, Yuan Y, Tao J, Chen C, Wu X, Liao Y, Wu L, Zeng Q, Chen Y, Wang K, Li X, Liu Z, Zhou J, Zhou Y, Li S, Zhu J. Which fetal growth charts should be used? A retrospective observational study in China. Chin Med J (Engl). 2022;135(16):1969-1977. doi: 10.1097/CM9.0000000000002335.
6. Rapisarda AMC, Somigliana E, Dallagiovanna C, Reschini M, Pezone MG, Accurti V, Ferrara G, Persico N, Boito S. Clinical implications of first-trimester ultrasound dating in singleton pregnancies obtained through in vitro fertilization. PLoS One. 2022;17(8):e0272447. doi: 10.1371/journal.pone.0272447.
7. Dan T, Chen X, He M, Guo H, He X, Chen J, Xian J, Hu Y, Zhang B, Wang N, Xie H, Cai H. DeepGA for automatically estimating fetal gestational age through ultrasound imaging. Artif Intell Med. 2023;135:102453. doi: 10.1016/j.artmed.2022.102453.
8. Gao J, Xiao Z, Chen C, Shi HW, Yang S, Chen L, Xu J, Cheng W. Development and validation of a small for gestational age screening model at 21-24 weeks based on the real-world clinical data. J Clin Med. 2023;12(8):2993. doi: 10.3390/jcm12082993.
9. You T, Frostick S, Zhang WT, Yin Q. Os Acromiale: Reviews and current perspectives. Orthop Surg. 2019;11(5):738-744. doi: 10.1111/os.12518.
10. Sherer DM, Plessinger MA, Allen TA. Fetal scapular length in the ultrasonographic assessment of gestational age. J Ultrasound Med. 1994;13(7):523-528. doi: 10.7863/jum.1994.13.7.523.
11. Lee ACC, Whelan R, Bably NN, Schaeffer LE, Rahman S, Ahmed S, Moin SMI, Begum N, Quaiyum MA, Rosner B, Litch JA, Baqui AH, Wylie BJ. Prediction of gestational age with symphysis-fundal height and estimated uterine volume in a pregnancy cohort in Sylhet, Bangladesh. BMJ Open. 2020;10(3):e034942. doi: 10.1136/bmjopen-2019-034942.
12. Self A, Papageorghiou AT. Ultrasound diagnosis of the small and large fetus. Obstet Gynecol Clin North Am. 2021;48(2):339-357. doi: 10.1016/j.ogc.2021.03.003.
13. von Falck C, Hawi N. Fracture diagnosis: upper extremities: Shoulder and shoulder girdle. Radiologe. 2020;60(6):541-548. doi: 10.1007/s00117-020-00682-6.
14. Murao F, Shibukawa T, Takamiya O, Yamamoto K, Hasegawa K. Antenatal measurement of scapula length using ultrasound. Gynecol Obstet Invest. 1989;28(4):195-197. doi: 10.1159/000293576.
15. Sarkar KN, Ghosh SK, Gupta KM, Srimani BB, Dhar R, Sarkar M. Foetal scapular length as a parameter for gestational age assessment. J Dental Med Sci. 2016;15(7):120-124. doi: 10.9790/0853-15075120124
16. Dilmen G, Turhan NO, Toppare MF, Seçkin N, Oztürk M, Göksin E. Scapula length measurement for assessment of fetal growth and development. Ultrasound Med Biol. 1995;21(2):139-142. doi: 10.1016/s0301-5629(94)00114-6.
17. Salim I, Cavallaro A, Ciofolo-Veit C, Rouet L, Raynaud C, Mory B, Collet Billon A, Harrison G, Roundhill D, Papageorghiou AT. Evaluation of automated tool for two-dimensional fetal biometry. Ultrasound Obstet Gynecol. 2019;54(5):650-654. doi: 10.1002/uog.20185.
18. Perl E, Waxman JS. Reiterative mechanisms of retinoic acid signaling during vertebrate heart development. J Dev Biol. 2019;7(2):11. doi: 10.3390/jdb7020011.
19. Qutbi M. Sprengel's deformity as congenital scapular asymmetry on bone scintigraphy. World J Nucl Med. 2019;18(1):61-62. doi: 10.4103/wjnm.WJNM_1_18.
20. Páscoa Pinheiro J, Fernandes P, Sarmento M. Bilateral Sprengel deformity with bilateral omovertebral bone: an unusual case in an adult patient: A case report. JBJS Case Connect. 2023;13(1)136. doi: 10.2106/JBJS.CC.22.00217.
21. Li H, Zhang H, Zhang X, Yao Z, Gao J, Liu H, Guo D, Zhang W. Surgical treatment of severe Sprengel's deformity: A case report. JBJS Case Connect. 2023;13(1). doi: 10.2106/JBJS.CC.22.00648.
22. Pai SN, Kumar MM. Sprengel deformity associated with winging of scapula, vertebral fusion, rib fusion and spina bifida occulta. BMJ Case Rep. 2021;14(10):e246815. doi: 10.1136/bcr-2021-246815.
23. Bisht RU, Belthur MV, Singleton IM, Goncalves LF. Prenatal diagnosis of Sprengel's deformity in a patient with Klippel-Feil Syndrome. Clin Imaging. 2021;78:45-50. doi: 10.1016/j.clinimag.2021.02.041.
24. Salian S, Nampoothiri S, Shukla A, Girisha KM. Further evidence for causation of ischiospinal dysostosis by a pathogenic variant in BMPER and expansion of the phenotype. Congenit Anom (Kyoto). 2019;59(1):26-27. doi: 10.1111/cga.12285.
25. Kattapuram M, Briones N, Mancuso J. Paired unilateral scapular pits in a neonate. Pediatr Dermatol. 2023;40(1):142-143. doi: 10.1111/pde.15125.
26. Kimball A, Bowen VB, Miele K, Weinstock H, Thorpe P, Bachmann L, McDonald R, Machefsky A, Torrone E. Congenital syphilis diagnosed beyond the neonatal period in the United States: 2014-2018. Pediatrics. 2021;148(3):e2020049080. doi: 10.1542/peds.2020-049080.
27. Amin MA, Shawon TA, Shaon NK, Nahin S, Fardous J, Hawlader MDH. A case of Pierre Robin syndrome in a child with no soft palate and complications from pneumonia in Bangladesh. Clin Case Rep. 2023;11(5):e7350. doi: 10.1002/ccr3.7350.
28. Gulersen M, Lenchner E, Eliner Y, Grunebaum A, Johnson L, Chervenak FA, Bornstein E. Risk factors and adverse outcomes associated with syphilis infection during pregnancy. Am J Obstet Gynecol MFM. 2023;5(6):100957. doi: 10.1016/j.ajogmf.2023.100957.
29. Hegde A, Srinivasan R, Dinakar C. Congenital syphilis: a rare presentation of a forgotten infection. J Infect Dev Ctries. 2023;17(1):135-138. doi: 10.3855/jidc.15498.
30. Wu W, Kamat D. A Review of benign congenital anomalies. Pediatr Ann. 2020;49(2):e66-e70. doi: 10.3928/19382359-20200121-03.