The study of the humerus and femur length as combined predictors of the gestational age of human fetuses using ultrasonography

Chaithra Rao B. R., Sunkeswari Sreepadma


Background: Ultrasound dating of pregnancy is the most effective and easiest method presently used to assess the gestational age of fetus. The study evaluates the diaphyseal lengths of humerus and femur as combined parameters to estimate the gestational age of the fetus at the time of examination.

Methods: The study was done on 152 pregnant women of gestational age from 15 to 40 weeks attending antenatal clinic of a certain medical college hospital. Subjects with maternal disease known to affect normal fetal growth, history of recurrent miscarriages and of chronic medications, multiple gestations or other complications and major fetal abnormalities were excluded. The diaphyseal lengths of humerus and femur were measured in a standardized manner. The relationship of the humerus and femur length in centimeters is compared with the gestational age in weeks. The multiple correlation equation of humerus and femur length with the gestational age was deduced.

Results: It was observed that the diaphyseal length of humerus and femur gradually increased from 15 weeks to 40 weeks of gestation and by applying multiple correlation, a formula was derived to calculate the gestational age.

Conclusions: The measurement of the humerus and femur length (in cm) can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses belonging to that geographical area using the derived formula.


Down’s syndrome, Femur, Fetal growth retardation, Fetus, Gestational age, Humerus, Ultrasonography

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Shehzad K, Ali M, Zaid S. Fetal Biometry. Pak J Med Sci. 2006;22(4):503-8.

Kinare AS, Chinchwadkar MC, Natekar AS, Coyaji KJ, Wills AK, Joglekar CV, et al. Patterns of fetal growth in a rural Indian cohort and comparison with a Western European population: data from the Pune maternal nutrition study. J Ultrasound Med. 2010;29(2):215-23.

Lee W, Deter RL, McNie B, Gonçalves LF, Espinoza J, Chaiworapongsa T, et al. The fetal arm: individualized growth assessment in normal pregnancies. J Ultrasound Med. 2005;24(6):817-28.

Scorza WE, Vintzileos A. First and second trimester sonography: an American perspective. Int J Fertil Menopausal Stud. 1996;41(3):288-92.

Johnson TRB, Gregory KD, Niebyl JR. Preconception and Prenatal Care: Part of continuum. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia: Churchill Livingstone Elsevier; 2007:111-137.

Salomon LJ, Bernard JP, Duyme M, Buvat I, Ville Y. The impact of choice of reference charts and equations on the assessment of fetal biometry. Ultrasound Obstet Gynecol. 2005;25(6):559-65.

Rice KJ, Ballas J, Lai E, Hartney C, Jones MC, Pretorius DH. Diagnosis of fetal limb abnormalities before 15 weeks: cause for concern. J Ultrasound Med. 2011;30(7):1009-19.

Rao CBR, Sreepadma S, Kalghatgi RN. The study of relation between the gestational age of human fetuses and the diaphyseal length of femur using ultrasonography. Int J Anat Res. 2017;5(1):3342-9.

Rosati P, Guariglia L, Capelli G. A new mathematical formula for predicting long bone length in early pregnancy. Ultrasound Obstet Gynecol. 2002;19(2):184-9.

Zorzoli A, Kustermann A, Caravelli E, Corso FE, Fogliani R, Aimi G, et al. Measurements of fetal limb bones in early pregnancy. Ultrasound Obstet Gynecol. 1994;4(1):29-33.

Exacoustos C, Rosati P, Rizzo G, Arduini D. Ultrasound measurements of fetal limb bones. Ultrasound Obstet Gynecol. 1991;1(5):325-30.

Silva LM, Jansen PW, Steegers EAP, Jaddoe VWV, Arends LR, Tiemeier H, et al. Mother’s educational level and fetal growth: the genesis of health inequalities. Int J Epidemiol. 2010;39(5):1250-61.

Lai FM, Yeo GS. Reference charts of fetal biometry in Asians. Singapore Med J. 1995;36(6):628-36.

Salpou D, Kiserud T, Rasmussen S, Johnsen SL. Fetal age assessment based on 2nd trimester ultrasound in Africa and the effect of ethnicity. BMC Pregnancy Childbirth. 2008;8:48.

Verburg BO, Steegers EA, De Ridder M, Snijders RJ, Smith E, Hofman A, et al. New charts for ultrasound dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based cohort study. Ultrasound Obstet Gynecol. 2008;31(4):388-96.

Zelop CM, Borgida AF, Egan JF. Variation of fetal humeral length in second-trimester fetuses according to race and ethnicity. J Ultrasound Med. 2003;22(7):691-3.

Kim SN, Park KH, Jung HJ, Hong JS, Shin DM, Kang WS. Clinical and sonographic parameters at 37 weeks' gestation for predicting the risk of primary Cesarean delivery in nulliparous women. Ultrasound Obstet Gynecol. 2010;36(4):486-92.

Ay L, Kruithof CJ, Bakker R, Steegers EA, Witteman JC, Moll HA, et al. Maternal anthropometrics are associated with fetal size in different periods of pregnancy and at birth. The Generation R Study. BJOG. 2009;116(7):953-63.