Decoding Fetal Growth: Exploring Proximal Tibial Epiphysis Ossification Center as an Additional Sonographic Fetal Biometry Parameter (34-40 Weeks Gestation)

Background: Many times, pregnant women don't know when they last had their period. Determining gestational age becomes extremely difficult when late booking for prenatal care is added. Study was conducted to ascertain the predictive values of proximal tibial epiphyseal ossification center measurements in estimating pregnancy in the third trimester.Objectives: To assess correlation between proximal tibial epiphysis ossification center diameter with respect to gestational age, from 34 weeks to 40 weeks of gestation. Materials and Methods: The study was carried out at Sughra Shafi medical complex, Narowal for a period of 9 months. Total 281 pregnant females were considered in this study which were within 34 weeks to 40 weeks of gestational age, with no-comorbidity and sure of their last menstrual period (LMP). An informed consent was taken. Measurement was repeated thrice, after confirming the proximal tibial epiphyseal ossification center and the largest diameter obtained in millimeters was recorded. Pearson correlation analysis was applied to see correlation between distal femoral epiphyseal ossification size and gestational age.Results: There is an increasing trend of the size of PTE ossification center (mm) as the gestational age proceeded from 34 weeks to 40 weeks. Pearson Correlation was applied. It was statistically significant indicating positive correlation indicated by coefficient of 1.Conclusion: In the third trimester, estimation of age of gestation by measuring the PTE is a reliable diagnostic tool in patients unsure of LMP as PTE appears in majority of patients by 34 weeks.Keywords: Gestational age, Last menstrual period, Ossification center, Proximal tibial epiphysis