Fetal dönemde üst ve alt ekstremite arasındaki büyüme oranları

Amaç: Çalışmanın amacı fetal dönem boyunca insan fetuslarında üst ve alt ekstremiteler arasındaki büyüme oranlarını belirlemektir. Gereç ve Yöntem: Bu çalışmada, eksternal anomalisi olmayan ve yaşları 9-40 gebelik haftası arasındaki 161 insan fetusu (83 erkek, 78 dişi) kullanılmıştır. Üst ekstremitede omuz genişliği, kol, önkol ve el uzunluğu ölçüldü. Alt ekstremitede intertrochanter mesafe, uyluk, bacak ve ayak uzunluğu ölçüldü. Bulgular: Fetal dönem ve gestasyonel yaşta alınan tüm parametreler arasında anlamlı korelasyon bulundu (p

The rate of growth between the upper and lower extremity in the fetal period

Purpose: The aim of this study was the determination of rates of growth between the upper and lower extremity of human fetuses during the fetal period. Materials and method: In this study, 160 human fetuses (80 males, 80 females) without external anomalies and aged between 9-40 post menstrual weeks were studied. In the upper extremity, the width of shoulder, the length of arms, forearms and hands were measured. In the lower extremity, the width of the inter trochanterica, the length of thigh, cruris and foot were measured. Results: Significant correlation was found between all parameters taken within the fetal period and gestational age (p<0.001). The rate of forearm growth was higher than the rate of arm growth, the rate of thigh growth was higher than the rate of cruris growth and in addition the rate of upper extremity growth was higher than the rate of lower extremity growth in the first and second trimesters. In all of these increasing rates, there were no differences between third trimester and full term groups (p<0.05). Conclusions. Our opinion is that the measurements can be useful to assess gestational age concerning several branches of medicine such as anatomy, pathologic anatomy (fetopathology), forensic medicine, medical imaging, obstetrics and pediatrics.

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  • 1. Sadler TW. Langman's Medical Embriyology. (6th Ed) USA: Williams & Wilkins Baltimore Maryland. 1990; pp 134-40.
  • 2. Collins P. Neonatal anatomy and growth. In Williams 1. PL, Warwich R, Dyson M, Bannister LH. Gray's Anatomy (38th Ed) London, Churchill Livingstone Medical Division of Longman UK 1995: pp 343-73.
  • 3. Hern WM. Correlation of fetal age and measurements between 10 and 26 weeks of gestation. Obstet Gynecol 1984; 63(1): 26-32.
  • 4. Taeusch HW. Initial evaluations: History and physical examination of the newborn. In: Taeusch HW, Ballord RA, Avery ME. Diseases of The Newborn. Philadelphia. W.B. Saunders Company 1991; pp: 207-24.
  • 5. Moore KL, Persaud TVN. Systema Skeletale ve Ekstremiteler. The Developing Human Clinically Oriented Embryology. Yıldırım M, Okan İ, Dalcı H. Nobel Tıp Kitabevleri. İstanbul 2002; 6. Baskı 405- 24, 433-50.
  • 6. Lacerda CAM. Foot length growth related to crown- rump length, gestational age and weigth in human staged fresh fetuses. Surgical Radiologic Anatomy 1990; 12: 103-7.
  • 7. Platt LD, Medearis AL, DeVore GR, Horenstein JM, Carlson DE, Brar Hs. Fetal foot length: Relationship to menstrual age and fetal measurements in the second trimester. Obstetrics & Gynecology 1988; 71(4): 526-31.
  • 8. Mercer BM, Sklar S, Shariatmadar A, Gillieson MS, D'Alton ME. Fetal foot length as a predictor of gestational age. Am J Obstet Gynecol 1987; 156(2): 350-5.
  • 9. Campbell J, Henderson A, Campbell S. The fetal femur/foot length ratio: a new parameter to assess dysplastic limb reduction. Obstetrics & Gynecology 1988; 72(2): 181-4.
  • 10. Johnson MP, Barr M, Treadwell MC, Michaelson J, Isada NB, Pryde PG, et all. Fetal leg and femur/foot length ratio: A marker for trisomy 21. Am J Obstet Gynecol 1993; 169(3): 557-63.
  • 11. Johnson MP, Michaelson JE, Barr M, Treadwell MC, Isada NB, Domprowski MP, et all. Sonographic screening for trisomy 21: fetal humerus:foot length ratio, a usefull new marker. Fetal Diagnosis & Therapy 1994; 9(2): 130-8.
  • 12. Grist TM, Fuller RW, Albiez KL, Bowie JD. Femur length in the US prediction of tirsomy 21 and other choromosomal abnormalities. Radiology 1990; 174(1): 837-9.
  • 13. Filly RA, Golbuss MS, Carey JC, Hall JG. Short- Limbed Dwarfizm: Ultrasonographic diagnosis by mensuration of fetal femonal length. Radiology 1981; 138: 653-6.
  • 14. O'Brien GD, Rodeck C, Queenan JT. Early prenatal diagnosis of diastrophic dwarfizm by ultrasound. British Medical Journal 1980; 31: 1300.
  • 15. Kastler B, Gangi A, Mathelin C, Germain P, Arhan JM, Treisser A, et all. Fetal shulder measurements with MRI. Journal of Computer Assisted Tomography; 1993; 17(5): 777-80.
  • 16. Munsick RA. Similarities of Negro and Caucasion fetal extremity lengths in the interval from 9 to 20 weeks of pregnancy. Am J Obstet Gynecol 1987; 156(1): 183-5.
  • 17. Hinrichsen KV. Human-Embryologie. Berlin-Germany 1990; 838-60.
  • 18. Callen PW. Ultrasonography in obstetrics and gynecology. W.B. Saunders Company. Philadelphia 1997. Çeviri Ed: Güner H. Obstetrik ve jinekolojide ultrasonografi. Bölüm çevirisi: Çakıcı C. Fetal kas iskelet sisteminin ultrasonografik değerlendirilmesi. Atlas kitapçılık Ltd. Şti. Ankara 1997: 286-327
  • 19. Mahony BS, Filly RA. High-resolution sonographic assessment of the fetal extremities. J Ultrasound Med 1984 3(11):489-98
  • 20. Brumfield CG, Hauth JC, Cloud GA, Davis RO, Henson BV, Cosper P. Sonographic measurements and ratios in fetuses with down syndrome. Obstetrics & Gynecology 1989; 73(4): 644-6.
  • 21. Lockwood C, Banecerraf B, Krinsky A, Blakemore K, Belanger K, Mahoney M, et al. A sonographic screening metod for Down syndrome. Am J Obstet Gynecol 1987; 157(4): 803-8.
  • 22. Benacerraf BR, Cnann A, Gelman R, Laboda LA, Frigoletto FD Jr. Can sonographers reliably identify anatomic features associated with Down syndrome in fetuses?. Radiology 1989; 173(2): 377-80.
  • 23. Saracoğlu F. Fetal tanı ve tedavi. Güneş Kitabevi, Ankara 1998; 636-77.
  • 24. Fischer AC, Manning FA, Jeanty P, Romero R. Sonography in obstetrics and gynecology: principles and practice. A Simon & Schuster Company 1996. Çeviri editörü Yüksel A. Bölüm çevirisi; Özeren S. Obstetrik ve Jinekolojide Sonografi: prensipler ve klinik uygulamalar. Ulusal Tıp Kitabevi İstanbul. 2000: 447-92.
  • 25. Nicolaides KH, Pilu G. Diploma in Fetal Medicine series. Çeviri; Ermiş H, Has R, Kalelioğlu İ, Erdoğdu C. Fetal anomalilerin prenatal tanısı, 18-25. gebelik haftası ultrasonu. The Parthenon Publishing Group, London. 2002: 87-98.
  • 26. Jacquemyn Y, Sys SU, Verdonk P. Fetal biometry in different ethnic groups. Early Hum Dev 2000 57(1):1-13.
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi-Cover
  • ISSN: 1300-7416
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1994
  • Yayıncı: SDÜ Basımevi / Isparta