Helped Over 500,000 patients with 98%+ satisfaction.

Connect & Get Personalized 1-to-1 Answers from Expert Doctors

DoctorSpring > Question Home

High CEPHALIC INDEX with low FEMUR LENGTH in ULTRASOUND.

Resolved Question:

Hello, I am currently 33 years old patientold and 37 weeks pregnant, and just had my last ultrasound checkup.
I was alarmed by certain results:
The CI (BPD/OFD) was 90%. I know the normal range is supposed to be no more than 84%, correct?
And the FL measured only 35 weeks along, which means it is two weeks behind.
HC/AC is 1.04

One month ago, when I was 33 weeks pregnant, my ultrasound showed:
FL/BPD: 63%
FL/HC: 18%
FL/AC: 19%
HC:AC: 1.06
and FL measured 29w3d along at that point, so it was 3 weeks behind then.

When i was 22 weeks pregnant, my ultrasound showed:
CI (BPD/OFD) at 77%, which was normal then.
HC/AC was 1.16, also in normal range then.


However the latest ultrasound showed that my baby has high CI combined with low FL, which I heard are soft markers for down syndrome, is that correct?

I did do the non-invasive cell free DNA blood test to test for downs when I was pregnant 13 weeks 3 days along. It tested for trisomy 21, 18, 13. The report came out normal and that the baby does not carry these chromosomal abnormalities. i had decided against the amniocentesis test because it was invasive.

And when I was pregnant 12w4d, the nuchal translucency measured 1.3mm, which was a good result.

I know all the tests I mentioned above all have some false positive rates, and are all not 100% accurate. But based on my latest ultrasound finding, do you think my baby has the possibility of having downs or other developmental complications? baby currently weighs 2950 grams at 37 weeks. I have hypothyroidism for five years old patientnow and am on medication everyday. The baby's high cephalic index of 90% is scaring me. please be frank with me. Does that mean I will have a difficult vaginal delivery because currently the baby's head is out of the normal range?

Thanks for your expertise.

Category: OBGYN

Ask Your Own Question

Category: Infertility Specialist
 32 Doctors Online

Hello. Thanks for writing to DoctorSpring.com with your health concern.
I understand your concern very well.
Before offering a definitive opinion, I would like to request for a few more details.
1. Is this your first pregnancy?
2. Any past history or family history of abnormal babies ?
3. Any diabetes ?
4. Please upload the latest scans and earlier ones too, not the images, that would be cumbersome, but the reports at least. That is easier for me to go through than reading the typewritten findings.

Looking forward to hearing from you.

Take care.


Patient replied :

To answer your questions: yes first pregnancy. No family history of abnormal babies on both sides, but I do have a cousin with autism. I tested for gestational diabetes and passed the test, don't have diabetes. i uploaded the scans from my 33 weeks and 37 weeks ultrasound reports for you to see.
THESE REPORTS ARE THE ONLY PAGES I WAS PROVIDED. I was not given any other "comments/conclusion" page.
From these numbers, please provide your diagnosis based on these reports, and what I described previously. Thanks for your feedback.


Hello,
Basically the CI is higher than average.
FL is less than gestational age.
What matters more is the CGA - composite gestational age, as the parameters might be slightly high or low compared to the normal, but the cumulative gestational age should approach the menstrual age.
In your case, I do not think there is any significant risk of Downs syndrome or other anomalies.
THe prenatal non invasive blood test is quite reliable.
Plus, the soft marker ( high CI with short femur ) is not very reliable and is of significance only in concert with other soft or specific markers, none of which are present in your case.
High CI just means a variant of the shape of the head, which is broader than longer.
It does not mean a difficult vaginal delivery even, as vaginal birth is decided by the size and shape of your pelvis too.
I would ask you to relax.
The FL is just 2 weeks behind, which is acceptable.
And I would not worry about the CI as long as the baby is essentially normal.
There is significant inter observer variation, and all earlier scans have been fine, so dont worry.
In my opinion, the risk of any anomaly is very remote.
Take care.


Patient replied :

Hello,
Basically the CI is higher than average.
FL is less than gestational age.
What matters more is the CGA - composite gestational age, as the parameters might be slightly high or low compared to the normal, but the cumulative gestational age should approach the menstrual age.
In your case, I do not think there is any significant risk of Downs syndrome or other anomalies.
THe prenatal non invasive blood test is quite reliable.
Plus, the soft marker ( high CI with short femur ) is not very reliable and is of significance only in concert with other soft or specific markers, none of which are present in your case.
High CI just means a variant of the shape of the head, which is broader than longer.
It does not mean a difficult vaginal delivery even, as vaginal birth is decided by the size and shape of your pelvis too.
I would ask you to relax.
The FL is just 2 weeks behind, which is acceptable.
And I would not worry about the CI as long as the baby is essentially normal.
There is significant inter observer variation, and all earlier scans have been fine, so dont worry.

In my opinion, the risk of any anomaly is very remote.
Take care.



Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

Users who read this, also read:

Make informed and better medical decisions.

Join the 500,000 people who found a smarter, quicker way to get Answers, Recommendations & Expert Opinions.

Expert Doctors at fingertips

Recommendation on next step. Second-opinion.Multi-specialty.

Save Time

Average time for answers: 6 hours.

Save Money

$35 for typical specialist consult vs. $120 for a local appointment.

Free Follow-ups

Clarify, ask further questions for free in private conversation.

100% Satisfaction

Money back guarantee for the 1st reply. MEDNET Quality Board.

Start My Consultation

CHAT NOW

About DoctorSpring.com

Doctor Spring is a novel online Doctor consultation platform where you can get your medical questions answered by leading Doctors. Just Submit your question and rest assured that you will consult a Doctor easily. Once you submit the question, the Doctor from the concerned specialty will reply within hours. You can always ask more questions or add details with follow-up question options and make it an online doctor chat. You may use this service to consult a specialty or for getting medical second opinion. All paid services come with a MEDNET quality assurance and 100% money back guarantee.

DoctorSpring in news