Dear Editor,
We agree with the comments of Dr. Abdin Elshikh on our article titled “Fetal Gestational Age Determination using Ultrasound Placental Thickness” which was published[1] in the January–March 2020 issue of the Journal of Medical Ultrasound.
Besides thalassemia/hemoglobinopathy mentioned by Dr. Elshikh, other causes of small placenta[2] (hypertensive disease of pregnancy, fetal growth restriction, trisomy 18, dygynic triploidy, intrauterine infection, variations in placenta morphology, etc.) or placentomegaly[3] (maternal anemia, maternal diabetes mellitus, hydrops fetalis, umbilical vein obstruction, placental chorioangioma, placental mesenchymal dysplasia, etc.) could also affect placenta thickness measurements – constituting the limitations of the method. Some of these abnormalities were the part of our exclusion criteria. Unsurprisingly, even the well-established biometric parameters (biparietal diameter, head circumference, abdominal circumference, and femur length) have their limitations.[4] It is noteworthy that thickened placenta is seen in only 0.6%–7.8% of obstetric sonography.[5]
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REFERENCES
- 1.Azagidi AS, Ibitoye BO, Makinde ON, Idowu BM, Aderibigbe AS. Fetal gestational age determination using ultrasound placental thickness. J Med Ultrasound. 2020;28:17–23. doi: 10.4103/JMU.JMU_127_18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Jones J. [Last accessed on 2021 Nov 17]. Available from: http://radiopaedia.org/articles/15188 .
- 3.Weerakkody Y, Jones J. Placentomegaly | Radiology Reference Article | Radiopaedia. [Last accessed on 2021 Nov 14]. Available from: https://radiopaedia.org/articles/placentomegaly .
- 4.Degani S. Fetal biometry: Clinical, pathological, and technical considerations. Obstet Gynecol Surv. 2001;56:159–67. doi: 10.1097/00006254-200103000-00023. [DOI] [PubMed] [Google Scholar]
- 5.Sun X, Shen J, Wang L. Insights into the role of placenta thickness as a predictive marker of perinatal outcome. J Int Med Res. 2021;49:300060521990969. doi: 10.1177/0300060521990969. [DOI] [PMC free article] [PubMed] [Google Scholar]