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Related Experiment Videos

Cephalic index: a gestational age-dependent biometric parameter.

D L Gray1, G S Songster, C A Parvin

  • 1Department of Obstetrics and Gynecology, Washington University School of Medicine, Jewish Hospital of St. Louis, Missouri.

Obstetrics and Gynecology
|October 1, 1989
PubMed
Summary
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The cephalic index, used for assessing fetal head shape, is not independent of gestational age. This study found significant variations, impacting biparietal diameter measurements in pregnancies.

Area of Science:

  • Obstetrics
  • Fetal Medicine
  • Medical Imaging

Background:

  • The cephalic index (CI) was historically used to identify abnormal fetal head shapes and validate biparietal diameter (BPD) measurements.
  • Previous research suggested the CI is independent of gestational age, a notion this study aimed to re-evaluate.

Purpose of the Study:

  • To investigate the relationship between cephalic index and gestational age in well-dated pregnancies.
  • To determine if gestational age influences CI and, consequently, the accuracy of BPD measurements.

Main Methods:

  • Regression analysis was performed on data from 777 pregnancies with gestational ages ranging from 14 to 40 weeks.
  • A separate cohort of 1361 normal fetuses was used to validate findings and establish a threshold for identifying misleading BPDs.

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Main Results:

  • A significant variation in cephalic index was observed with advancing gestational age.
  • The highest CI values were noted at 14 weeks, with the lowest at 28 weeks of gestation.
  • A threshold of +/- 1 standard deviation (SD) effectively identified inaccurate BPD measurements caused by altered fetal head shape.

Conclusions:

  • The cephalic index is dependent on gestational age, contrary to previous assumptions.
  • Gestational age-independent CI values are not reliable for assessing fetal head shape and BPD accuracy throughout pregnancy.
  • The proposed +/- 1 SD threshold aids in detecting misleading BPD measurements due to cephalic index variations related to gestational age.