Duphaston's analogue is cheaper. Means with a similar effect

In the article we discuss the KTR of the fetus by weeks, the features of its measurement and possible deviations from the norm. You will find out what is the KTR norm, depending on the period by weeks and days of pregnancy, what to do if the indicators are less or more than normal.

Fetal KTR is calculated to control its development

Fetal KTR is determined during ultrasound in the 1st trimester of pregnancy to clarify the gestational age or gestational age of the fetus- the number of completed weeks from the first day of the last menstruation to delivery.

Fetal KTR - what is it? The coccygeal-parietal size is the maximum distance from highest point crown of the child to the lowest point of his coccyx. This value is not affected by gender, skin color, nationality, or geographical latitude, neither ecology nor others individual characteristics mother and child.

With the help of the KTR of the fetus, the rate of development of the baby is estimated by weeks of pregnancy, judge the dynamics of its growth, the possibility of large fetuses or delay prenatal development. At the same time, KTR and fetal heart rate are measured week by week. Heart pulsation is noticeable already at week 5 and allows you to clarify the presence of pathologies in the development of the child. If a deviation from the norm is detected, the doctor prescribes corrective therapy, and the woman can give birth to a healthy child.

Also, in the period from the 7th to the 14th week, the KTR of the fetus by weeks from conception establishes the exact gestational age and the preliminary date of birth. The more weeks have passed since conception, the more coccygeal-parietal size. Although this parameter is reliable only in the 1st trimester of pregnancy. Then the child becomes larger, the ultrasound sensor cannot cover the distance from the head to the coccyx at a time, and the doctor evaluates the rate of development of the baby by other sizes - chest, head, etc.

How is fetal CTE measured?

Diagnostics is done in a strictly sagittal projection, when the body of the embryo is visually divided into two halves so that the long measuring axis of the sensor runs in the direction from the parietal part of the fetal head to the coccyx.
If the baby does not move, the doctor takes the necessary readings.
If the child is very mobile, the doctor waits for the moment when the fetal body straightens as much as possible, takes a freeze-frame and fixes the measurement.

Measurement accuracy is +/- 3-4 days.

Fetal KTR norms by week

Ultrasound is performed to calculate the CTE of the fetus

The value of the KTR of the fetus obtained on ultrasound is compared with a statistical table of the dependence of the coccygeal-parietal size of the fetus on the gestational age. It shows the average indicators characteristic of a particular week of pregnancy, as well as the maximum and minimum values that are within the normal range.

When comparing your results with the fetal KTR table by week and day, focus on average value indicator is the absolute norm. Don't try to fit tenths of the minimum and maximum values. If you have a CTE = 23.7 mm, then your gestational age is 9 weeks and 1 day. Also keep in mind that the child grows every day, and his coccyx-parietal size increases daily by 1-2 mm. Therefore, analyze the results strictly by day, not by week.

Gestational age (week + day)	MIN limit KTR, mm	Average value of CTE, mm	MAX KTR limit, mm
5+0	not defined	1,2	4,3
5+1	not defined	1,4	4,6
5+2	not defined	1,7	4,9
5+3	not defined	2,0	5,3
5+4	not defined	2,3	5,7
5+5	not defined	2,7	6,1
5+6	not defined	3,1	6,6
6+0	not defined	3,5	7,1
6+1	0,4	4,0	7,7
6+2	0,8	4,6	8,3
6+3	1,3	5,1	8,9
6+4	1,9	5,8	9,6
6+5	2,5	6,4	10,4
6+6	3,1	7,1	11,1
7+0	3,8	7,9	11,9
7+1	4,5	8,7	12,8
7+2	5,3	9,5	13,7
7+3	6,1	10,4	14,7
7+4	6,9	11,3	15,6
7+5	7,8	12,2	16,6
7+6	8,7	13,2	17,7
8+0	9,7	14,2	18,8
8+1	10,7	15,3	20,0
8+2	11,7	16,4	21,1
8+3	12,8	17,5	22,3
8+4	13,9	18,6	23,5
8+5	15,0	19,9	24,7
8+6	16,2	21,1	26,1
9+0	16,3	22,0	27,0
9+1	17,0	23,0	29,1
9+2	18,1	24,2	30,0
9+3	19,0	25,0	31,0
9+4	20,2	26,1	32,0
9+5	21,0	27,0	34,1
9+6	22,1	29,0	36,0
10+0	24,2	31,1	38,0
10+1	25,3	33,1	41,0
10+2	26,0	34,0	42,0
10+3	27,1	35,0	43,2
10+4	29,0	37,1	45,0
10+5	31,0	39,3	47,2
10+6	33,0	41,1	49,0
11+0	34,0	42,2	50,1
11+1	35,1	43,0	51,0
11+2	36,0	44,2	52,1
11+3	37,0	45,3	54,1
11+4	38,1	47,0	56,0
11+5	39,0	48,2	57,1
11+6	40,1	49,0	58,3
12+0	42,0	51,3	59,0
12+1	44,0	53,0	62,0
12+2	45,1	55,0	65,1
12+3	47,0	57,1	67,1
12+4	49,1	59,3	69,2
12+5	50,0	61,2	72,0
12+6	51,0	62,0	73,4
13+0	52,1	63,0	75,0
13+1	53,1	65,2	77,0
13+2	54,0	66,0	78,2
13+3	56,0	68,1	80,0
13+4	58,0	70,0	82,1
13+5	59,2	72,0	85,2
13+6	61,0	74,0	87,2
14+0	63,0	76,0	89,0

Possible deviations from the norm

If, when compared with the KTR of the fetus, the deviations are insignificant, there is no need to worry. Be careful if the CTE value differs by 1 week or more or 7-10 mm. This speaks of a possible pathological course pregnancy.

CTE less than normal

What could be the reasons that the KTR of the fetus is below normal, what to do:

late onset ovulation and late fertilization, for example, after withdrawal hormonal contraceptives- after 10-14 days, do a control ultrasound to determine the KTR of the fetus and a more accurate gestational age;
infections, including those of the urogenital tract - get tested for STIs and, depending on the results, undergo antibiotic therapy;
hormonal disorders due to progesterone deficiency - take a blood test to determine the level of hormones and be treated with Duphaston and Utrozhestan;
genetic diseases fetus, for example, Shereshevsky-Turner syndrome, Patau, Down - sign up for a biochemical examination and, if changes are detected, undergo cordocentesis (fence cord blood) or amniocentesis (amniotic fluid sampling) for accurate detection of pathology.

One of the reasons why the CTE is less than normal is an undeveloped or missed pregnancy. In this case, the child dies in the early stages and his KTR corresponds to the level at which he was at the time of his death according to the KTR of the fetus by week of the table. The doctor checks the baby's heartbeat. With a short period and the absence of heart contractions, he conducts a second ultrasound in 5-7 days. If the diagnosis confirms that the baby is not growing, an emergency is prescribed. medical interruption pregnancy or curettage of the uterine cavity.

A multiple pregnancy also causes a discrepancy between the KTR of the fetus by weeks of pregnancy in the ultrasound table. Although this is not a pathology.

KTR is more than normal

When a woman doesn't remember the day last menstrual period or she has had early ovulation, obstetric term is assigned with an error and when measuring the CTE, the values \u200b\u200bexceed the norm. In this case, the gynecologist measures the CTE for several weeks. If the indicators symmetrically and consistently exceed the norm, the gestational age is recalculated, and the preliminary date of birth is transferred to an earlier period.

Sometimes the KTR of the fetus is higher than normal due to the fact that the child grows large with a weight of more than 4 kilograms after childbirth. What to do in this case:

limit your diet;
stop taking multivitamins;
stop taking metabolite drugs.

What else explains the increase in CTE:

Rhesus conflict;
diabetes;
neoplasms.

KTP is growing slowly

In some cases, a pregnant woman has another problem - the CTE of the embryo grows too slowly by weeks. Starting from the 5th week, the baby has a heartbeat, and from the 8th week, he begins to move. But his growth is falling further and further behind the norm every week. Doctors identify several reasons for this pathology:

genetic pathologies of the fetus - the diagnosis can be confirmed either by an expensive non-invasive prenatal DNA text from 8 weeks of gestation or by screening from 10-13 weeks of gestation;
insufficiency of the endometrium of the uterus after an abortion - this often occurs when a woman has not survived a certain period after a miscarriage; if, in parallel with the low growth of CTE, cervical erosion or its eversion towards the vagina is diagnosed, the risk of a second miscarriage is very high; needed urgent hospitalization pregnant;
Rh-conflict pregnancy - after several births, sensitivity female body with Rhesus conflict becomes so strong that from the first weeks new pregnancy the production of antibodies increases, which, among other things, slow down the development of the embryo.

KTR is growing too fast

If you had an ultrasound at 11 weeks and then did another scan only at 14 weeks, you may feel that your CTE is rising too fast. You worry in vain, because after 12 weeks the baby grows by 1-2 mm every day.

You should be concerned if the CTE of the embryo grows above the norm before 12 weeks. As a rule, the rapid growth of the baby is explained by the following:

congenital pathologies of the fetus;
Rh-conflict of mother and child;
metabolic disorders in pregnant women.

For more information about early pregnancy, see the video:

What to remember

The KTR of the fetus is the coccygeal-parietal size, which shows the distance to top point parietal zone of the child's head to his coccyx.
KTP is determined by ultrasound and compared with the absolute norm from the table, where the size depends on the gestational age by weeks and days.
Most often, CTE is less than normal due to hormonal disorders in the body of matter, infectious diseases, fetal death or its genetic pathologies, such as Down syndrome or Patau.
KTR more than normal is diagnosed when the obstetric gestational age is incorrectly determined or the mother grows big baby weighing from 4 kg.
If the KTR increases too slowly, the cause may be endometrial insufficiency of the uterus or an Rh-conflict pregnancy.
If the CTE is growing rapidly, the mother probably has a metabolic disorder.

When a woman is in a special position, she requires maximum attention from medical workers. That is why pregnant women are often prescribed various procedures, such as, for example, ultrasound diagnostics. In this article, I would like to understand such an abbreviation as KTR: what it is and how important these indicators are.

About the concept

Women in position undergo at least three ultrasound scans for all nine months of bearing crumbs. And they know that in such a study, the doctor determines the various parameters of the baby, including its size. It is worth noting that certain indicators correspond to each period of embryo development, according to which a specialist can say whether the pregnancy is proceeding normally. How does such an abbreviation as KTR stands for, what is it? This is the coccyx-parietal size of a child in the womb.

What is it for?

Why know these indicators? They are correlated with the body weight of the crumbs and thanks to this, the exact gestational age is calculated (taking into account, of course, the date of the last menstruation). So, in that, KTR - what it is, figured it out. Now it is worth mentioning that these indicators are very important just before the 11th week of pregnancy, sometimes even up to the thirteenth. After this time, other indicators come to the fore, by which it will be possible to determine how correctly the baby develops in the womb.

Methodology

How can a doctor take such measurements to find out what it includes? These parameters medical worker measured during a procedure such as an ultrasound. At the same time, neither the woman herself nor her child will feel anything at all. The doctor will measure the baby from the crown of the head to the coccyx, correlate these indicators with the table and draw certain conclusions.

It is worth saying that the longer the gestational age, the greater the CTE of the embryo. What does it mean? It's simple: the child grows, and its size increases. How will the doctor receive these figures? He will need to scan the woman's uterus in various projections, choose the one where the baby is best seen from the point of view of this measurement, and take measurements. If we imagine what the baby is at this time (a kind of body in the form of a worm, which is slightly bent in a circle), the question arises of how the doctor can correctly find out these parameters. Measurements should be taken at a time when the embryo is stretched to the maximum. Also more accurate results are obtained at a time when the baby has the least physical activity.

Time

It is also important to say when these figures can be known. So, the ideal time for the first ultrasound, when the KTR of the fetus becomes known, is approximately women. It is at this time that the main assessment of fetal growth is carried out (the most important indicator during this diagnosis), and the work of his heart is also viewed. It is also important to say that it is thanks to these figures that the gestational age can be specified. After all, before that it is very approximate, as it is based on simple calculations since the last menstruation. Formerly a woman ultrasound diagnostics may be prescribed if there are some concerns of the doctor regarding the life and health of both the mother and the embryo.

Norm

Having understood the KTR abbreviation (what it is and why it is needed), it is also important to say about the normal indicators that should be obtained by this measurement. Exist certain tables, in which certain numbers are painted for each week. By checking these indicators, you can find out if everything is in order with the baby. It is worth saying that before the sixth week of pregnancy, ultrasound is done quite rarely, so tables often begin from the seventh week of the embryo's life. However, for a five-week-old child, the size is 5 mm, for a six-week-old - 6 mm. But further this trend will not be maintained, as the baby will grow and develop faster. Already at the seventh week, the KTR of the baby should be approximately 10 mm, at the eighth - 16 mm, at the ninth - twenty-three. The deadline for the first ultrasound of a pregnant woman to be performed is the 14th week. At this time, the CTE of the embryo will already be as much as 63 mm! Learn more this indicator not so important (and doctors do not attach this special significance), because completely different numbers will come to the fore.

Big deviations

So, we figured out what KTR is, what it means, we also considered ideal indicators. But, unfortunately, this is not always the case. Quite often, the indicators deviate from normal in one direction or another. Generally speaking, too fast growth embryo may indicate that the child will be large and at birth can weigh up to 4 kg. It may also indicate that the gestational age was initially set incorrectly.

Downward deviations

What indicators can a pregnant woman find out when she does an ultrasound? KTR. What is it - it is clear. Coccyx-parietal size. However, sometimes there are situations that the numbers are slightly lower than those indicated in the table. What can it say? First, again, that the wrong gestational age was initially set. Do not be afraid, this often happens in the early stages, and later these figures can be adjusted. If the embryo does not grow, this may also indicate that the fetus has froze in its development, that is, it has died (it is easy to determine this by the presence or absence of heart contractions, as well as by the movements of the child).

It is not uncommon for a mother's hormonal deficiency to cause a miscarriage. Disrupt growth and may various infectious diseases that may be in the mother's body. This is also worth knowing. An embryo can develop too slowly even if it has certain genetic diseases. For example, Patau, Edwards. Diseases can also affect the growth of the baby in the womb internal organs women, cardiovascular problems, as well as disruption thyroid gland. Well, the last reason why a child can develop too slowly in the womb is various violations uterine mucosa, which may occur as a result of previous abortions.

Twelve weeks of pregnancy is a significant date for a woman, as this is the end of the first trimester. During this period, the placenta produces enough progesterone, and with the extinction hormonal function gradually decreases corpus luteum. At this time, the first trimester is screened (from 11 to 13 weeks and 6 days), to identify risk groups chromosomal abnormalities, and . Ultrasound examination at 12 weeks of pregnancy, the development of the fetus shows very accurately, especially the term indicator.

An important measurement, which is of paramount importance, is the CTE of the fetus at 12 weeks. This indicator is used to determine the size of the fetus and calculate the duration of pregnancy in conjunction with the approximate weight. The coccygeal-parietal size of 12 weeks is about 5.3 cm. If it passed without complications, and it grew by 1 mm per day, then the human embryo of 12 weeks accelerates the growth rate to 1.5-2 mm per day. Doctors recommend measuring the fetal CTE at 11 or 12 weeks.

It should be borne in mind that the value of the coccyx-parietal size depends on the gestational age up to a day, so the normal error is three to four days. The normal average CTE of an embryo is 51 mm. With a slight deviation, do not worry - normal fluctuations from 42 to 59 mm are possible.

For comparison, we indicate the KTR of the fetus at 11 weeks: normal rate is 42 mm, tolerances are normally 34-50 mm. When comparing these indicators, it can be seen how important every day is for ultrasound.

Of course, expectant mothers are interested in how the fetus looks and what it can do at 12 weeks. During an ultrasound, a mother can see her baby sucking her thumb and hear a 110-160 beat per minute beat. little heart. The baby actively moves and rolls over amniotic sac The chest moves up and down as you breathe. Also, the fetus already has the ability to close his eyes, open his mouth and wiggle his fingers.

With regard to development indicators, it is worth noting the maturation thymus, which is responsible for the production of lymphocytes by the body and the development of immunity. The pituitary gland begins to produce hormones that affect the growth of the fetus, the body's metabolism and reproductive function organism. The liver of the embryo begins to produce bile, which will help in the digestion of food. Digestive system ready to digest glucose.

The embryo of 12 weeks weighs about 9-13 grams, the fetus is stretched and is in sitting position. The length from the crown to the sacrum is approximately 70-90 mm. The embryonic heart by this time has four chambers: two atria and two ventricles, and the contraction rate varies from 150 to 160 beats per minute. The bone palate begins to form, the rudiments of milk teeth, and the vocal cords form in the larynx.

This period of development is especially important for boys. In progress active action testosterone, which is produced by the gonads of boys, begins the formation of the external genitalia - the penis and scrotum. In case of violation of this function, hermaphroditism can be observed.

What does mom feel at 12 weeks pregnant?

In the normal course of pregnancy and the development of the fetus, the pregnant woman should gain from 1.8 to 3.6 kg. The rate of weight gain is from 300 to 400 grams per week. If you gain more than normal weight, reduce the amount simple carbohydrates(sweets, cookies, halva, etc.).

Many women are concerned about the appearance of age spots on the face, neck, chest at this time, as well as the appearance of a dark line from the navel to the pubis. However, you should not worry, these are normal manifestations, and they will soon pass the field of childbirth.

An embryo at 12 weeks has successfully passed the embryonic life path and after 12 weeks is called a fetus. In our article future mom find a lot useful information to learn more about your future baby.

KTR is an abbreviation for the coccygeal-parietal size. It is measured from the most protruding part of the head to the tailbone of the child. This parameter is fundamental in calculating the exact gestational age. Virtually no difference between representatives of different races or gender.

When pregnancy is initially diagnosed by irregularities in the menstrual cycle, the most accurate timing of fetal development can only be determined by CTR. If at the beginning of pregnancy menstruation remains regular, the doctor for more exact definition fetal age compares the results of ultrasound with the indicators of CTE obtained the next day after the end of menstruation.

The determination of KTR occurs during sagittal scanning, since only such an angle allows the most complete picture of the position of the spine to be presented. The sagittal plane visually divides the human body in half. When the fetus is very active, they wait for the moment of its most complete extension, and then take a picture.

KTR is significant up to 16 weeks of pregnancy, since at subsequent terms exact age The fetus can be quite accurately traced by ultrasound.

When the CTE is slightly off the mark, there is no cause for concern. It can be assumed from this indicator that physiological features in a baby, however, it will not be possible to accurately predict its development.

If the CTE increases by one value over several weeks, there is a chance of developing a very big baby, whose birth weight will be 4 kg or more. When tracing such a situation, it is impossible to accept a large number of drugs that improve metabolism. In the case of a strong growth of the fetus, they can provoke its gigantic parameters, in which it can reach 5 kg before birth or exceed this value.

Features or developmental disorders of the fetus, which are indicated by a discrepancy between the KTP value and the norm

With a slight deviation of the CTE in a larger direction, we can assume the presence birth defects, neoplasms, Rhesus conflict, which, if necessary, is checked by passing a set of analyzes. If the mother has diabetes, this disease can also lead to weight gain in the baby.

When CTR is much lower established norm, this indicator indicates the presence of such features or violations:

With strong deviations of the KTR of the fetus from the norm, the following pathologies can be suspected:

Violations in the work or structure of the internal organs of the expectant mother. This is how heart disease is expressed, even birth defects, which practically did not appear before pregnancy. Developmental abnormalities in a child may indicate thyroid problems. It is advisable to start their elimination even during the gestation of the fetus, so that the disturbed hormonal background does not cause serious deviations in the development of the baby at a later date.

The consequences of abortion. Sometimes these operations pass without a trace at first glance, and Negative consequences are detected only during pregnancy. Usually, the uterine mucosa becomes defective due to the scraping of its walls when getting rid of the previous fetus. The same consequences can be expected when undergoing other surgical interventions that were dictated by a miscarriage or unsuccessful delivery with the need for subsequent cleaning of the uterus. mucosal pathology or developing fibroids impede normal growth child. Sometimes such violations indicate the likelihood of spontaneous miscarriage.

From the 5th week of pregnancy, it is possible to monitor the cardiac activity of the fetus, since this organ is already fully developed. Movements are visible only from 8 weeks. At this time, the child has muscles, so the movements of the limbs can be not only passive, but also sweeping. At the same time, they are deprived of balance, which is the norm at this time.

It is advisable to measure the CTE at the 11th week of pregnancy. At this time, all diagnostic parameters of the fetus can be covered. At this time, it is possible to detect the majority possible pathologies, which is a timely action for deciding whether to continue the pregnancy. Deviations from the norm stand out even with minimal differences in fetal indicators from those indicated in the table.

matters and accelerated growth baby, for example, if at the 12th week of pregnancy the KTR was 52 mm, and at the 13th week it grew to 66 mm, you need to be examined for pathologies in the development of the fetus or in your health.

From 12 weeks, the CTE value ceases to increase by 1 mm in 7 days. This indicator grows by 1.5-2 mm per day. To decipher the results of KTR, you need to consult a doctor, because without proper experience, parents can make mistakes with the indicators and draw wrong conclusions. After 16 weeks, the KTP measurement is stopped, since other methods of diagnostic studies are of greater importance.

The average values of the size of the fetus and uterus by ultrasound

Ultrasound diagnosis of pregnancy.

The average size of the ovum in the first trimester of pregnancy

The relationship of the coccygeal-parietal size (KTR) with the gestational age (according to the last menstruation)

Relationship between biparietal size (BDP) of the fetal head and gestational age (according to the last menstruation)

BRGP(BPR) - biparietal size heads. DB - thigh length. DGRK - diameter chest. Weight - in grams, height - in centimeters, other indicators in millimeters.

Fetal KTR by week

In today's publication, we will talk about the coccygeal-parietal size of the fetus (KTR) - an important indicator that plays a huge role in determining the duration of pregnancy. Therefore, if you are in interesting position” or are planning a pregnancy, then the information will be of interest to you.

KTP and gestational age, how is KTP calculated?

To begin with, CTE is almost entirely dependent on the gestational age and is practically not affected by factors such as fetal gender, race, or other individual characteristics. But with the help of KTR indicators in women who suffered from irregularities in the menstrual cycle before pregnancy, it is possible to almost accurately determine the gestational age. After all, it is no secret that the obstetric term for problems with the cycle can often be erroneous.

The calculation of the CTE is carried out starting from the 11th week of pregnancy. In this case, a normal error of 3-4 days is allowed both in one direction and in the other direction, since the embryo grows quite quickly. It should be noted that after the 16th week, KTR is usually not measured; after this period, other indicators matter.

Measurement of the coccyx-parietal size is carried out by sagittal scanning of the fetus. Note that the sagittal plane divides the body into two symmetrical halves, from front to back. If during the measurement the baby moves, then the specialist will fix the KTR at the moment of maximum extension.

Following the table of KTR values, the doctor determines the gestational age. In principle, you can compare or study the results yourself, since we will also present a table of values in today's publication.

How to decipher KTR indicators?

It should be noted that as the gestational age increases, the KTR of the fetus will also increase, which, by the way, makes it possible to control the course of pregnancy. If in the first trimester an ultrasound examination is performed more than once, then the dynamics of the change in CTE should also be assessed. At the same time, it is important to know that a rapid increase in KTR indicators may indicate the development large fruit, which during childbirth can reach 4 kg.

In the case when the KTR of the fetus strongly deviates from the norm downward, this may indicate the following:

the obstetric term was initially set incorrectly;
pregnancy does not develop, that is, the fetus died. However, it is easy to exclude this situation by the presence of heart contractions and by his physical activity;
hormonal deficiency, which can cause miscarriage;
infectious diseases that are the root cause of fetal growth disorders;
genetic disorders (Down, Edwards, Patau syndromes);
diseases of the internal organs of a pregnant thyroid disease, heart problems;
diseases or disorders of the uterine mucosa, which are most often manifested as a result of previous abortions.

Based on the foregoing, we can conclude that the coccyx-parietal size is the most important indicator that allows you to determine or clarify the gestational age, as well as identify the need for additional examinations, in case of suspected violation normal course pregnancy. Therefore, do not neglect the appointments of your doctor and be examined on time so that your baby is born healthy and strong.

Especially for beremennost.net Ira Romaniy

KTR (coccyx-parietal size) of the fetus by week

Ultrasound diagnostics is practically the only opportunity for a future mother and doctors antenatal clinic assess fetal development. On this moment there is no safer and more reliable method to do this, especially in early pregnancy when new life is just being born. chief ultrasonic indicator development of the fetus in the uterine cavity is the coccyx-parietal size. After the appearance of a regular heartbeat in the embryo, it is evaluated using fetal CTG.

What is the point of the indicator?

The coccygeal-parietal size (KTR of the fetus) is the length of the embryo in millimeters per different terms pregnancy. At the time of a routine ultrasound or an accidental detection of pregnancy, a fetal evaluation should be performed. Since in the early stages it has a curved shape, and its body is represented only by the torso and head, measurements can only be made within them. In this case, the coccygeal-parietal size is considered from the very extreme point head of the embryo to the end of the body. Responsible points of this measurement are, respectively, the crown and coccyx. Hence the name of the indicator.

Sometimes the term KTR is confused with fetal CTG. These two are perfect different indicators diagnosed with ultrasound. The fundamental difference is that CTG during pregnancy is called cardiotocography. This method has nothing to do with the coccyx-parietal size. With CTG of the fetus, its heartbeat is assessed and contractility uterus in childbirth or with the threat of termination of pregnancy.

When is CTE measured?

Fetal KTR by week refers to indicators of its development in early pregnancy. This is the period from conception to laying and initial development all organs and systems. The last process that limits the feasibility of further measurement of CTE is placentation (the formation of the placenta in the uterus - the only barrier that protects the child). The standard period of pregnancy, during which the coccyx-parietal size of the fetus is measured, is from 6 to 13-14 weeks. Therefore, the first ultrasound in a planned manner is recommended to be carried out precisely at these times.

KTP value

It is impossible to overestimate the value of the coccyx-parietal size. After all, the embryo in the early stages of development still does not have any clearly formed organs, except for the body and heart. It is possible to assess its condition only indirectly, by measuring these available indicators.

After obtaining the CTE value, it is compared with standard norms which are presented in the form of tables. The indicators that are displayed in them are the average norm adopted at the international level. The KTR of the fetus depends on the duration of pregnancy and intrauterine development. Up to 13 weeks, the embryo grows by 1 mm per day.

If the data obtained from ultrasound correspond to the standard values, this means that everything is fine with the child and there are no threats at this stage of development. If the coccyx-parietal size is lower normal values, this indicates intrauterine growth retardation. This situation is the reason for more detailed studies with the solution of the issue of further tactics of pregnancy management.

When evaluating the CTE by week, you can not only determine the condition of the embryo, but also find out the approximate gestational age. Therefore, in the antenatal clinic, two terms of pregnancy are established: according to the delay of menstruation and according to ultrasound. Further monitoring of the pregnant woman and the development of the fetus allows you to more accurately know the gestational age and the estimated date of birth.

An analogue of the coccygeal-parietal size at a later date is fetal cardiotocography (fetal CTG). If the first KTP gives information about the size of the child, then the second one tells about his functionality. CTG during pregnancy is advisable to record after 20 weeks. The method is a sound and graphic recording of the baby's heartbeats and uterine contractions. Fetal CTG is performed during pregnancy without much difficulty.

Normal fetal KTR by week of pregnancy

The tables below show the standards and decoding of the KTR of the fetus for embryos at a gestational age (intrauterine development) from 6 to 13 weeks. taken into account daily fluctuations during the week.

What does KTR say?

As the gestational age increases, the KTR of the fetus by weeks also gradually increases. This makes it possible to indirectly judge the course of pregnancy. If ultrasound is performed several times in the first trimester, then the dynamics of changes in CTE must be evaluated.

The rapid growth of KTP may indicate the development of a large fetus (more than 4 kg) in the future. In this case, do not use medicines metabolic nature (actovegin, multivitamins), as they can contribute to the birth of a real "hero".

If the KTR of the fetus by weeks strongly deviates from the norm downwards, then the following options are possible:

Incorrect obstetric term. Ovulation could be late, and therefore fertilization came later. In this case, everything is fine, but, as a rule, a second ultrasound is prescribed after 7-10 days to determine the dynamics.

Non-developing pregnancy, that is, the embryo/fetus died. It is easy to exclude by the presence of fetal heart contractions and its physical activity. This situation requires urgent medical care- curettage of the uterine cavity and removal of the fetus. Delay can cause serious violations reproductive health women, up to infertility, or even a threat to life, since bleeding, an infectious-toxic state, and even shock are possible.

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Hormonal deficiency(usually a lack of progesterone) can cause spontaneous abortion. With such a suspicion, additional examinations are prescribed to determine the quality hormonal background. Upon confirmation of the diagnosis, the doctor will prescribe drugs for hormonal support(Dufaston, Utrozhestan).

infectious factor can also cause fetal growth failure. At the same time, it is necessary to examine the woman for infections (including sexually transmitted infections), and if they are detected, rational therapy is prescribed within the allowed time frame.

Genetic disorders(Down, Edwards, Patau syndromes). In this case, an additional consultation with a geneticist is necessary, delivery genetic markers, the study of the chromosomal set of the fetus. To this end, in the first trimester, along with ultrasound, on which KTR is determined, biochemical screening. If both ultrasound and biochemical parameters have deviations, then the woman is invited to make additional such diagnostic procedures: amniocentosis (analysis amniotic fluid), cordocentesis (the study of cord blood) or a biopsy of the chorionic villi.

Diseases of the internal organs of a pregnant woman(diseases of the thyroid gland, heart).

Violations of the mucous membrane of the uterine cavity as a result of previous abortions. In this case, the fertilized egg is not able to implant and develop normally.

Thus, the coccygeal-parietal size is the most important indicator that allows you to determine or clarify the duration of pregnancy, as well as to identify the need for additional examinations, in case of suspicion of a violation of the normal course of pregnancy.

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The table shows the KTR values from 10 to 14 weeks, since it is at this time that ultrasound screening is performed in the first trimester of pregnancy.

Deviation from KTR norms

Additionally If the measured CTE slightly deviates from the average values up or down, you should not be scared. This only speaks about the characteristics of a particular fetus.

An increase in CTE by 1 or more weeks usually involves further development large fruit (more than 4 kg). In such a situation, it is necessary not to abuse metabolic drugs (actovegin, multivitamins), which can contribute to the development of a large and even giant (more than 5 kg) fetus. It is also necessary to exclude anatomical defects (neoplasms), maternal diabetes mellitus, Rhesus conflict, although this pathology usually manifests itself in the second and third trimester of pregnancy.

If KTR, then there are several options:

Fertilization came later due to the later (release of the egg from the follicle) and, accordingly, the gestational age is less than the period from the first day of the last menstruation, that is, this is a variant of the norm. In this case, it is necessary to repeat the ultrasound in dynamics in 7-10 days.
at which the embryo/fetus dies. It can be ruled out by the presence of rhythmic fetal heartbeats. normal frequency(see the norm for the fetal heart rate in the article “Ultrasound Norms by Week”) and its motor activity. Non-developing pregnancy requires urgent (emergency) care- curettage of the uterine cavity to remove the fetus, as it can cause serious violations reproductive health (infertility) and even a threat to a woman's life (bleeding, infectious-toxic conditions up to shock).
(most often progesterone deficiency) - can lead to spontaneous abortion. This state requires additional examination on the quality of the hormonal background and hormonal support in case of its insufficiency (Dufaston, Utrozhestan - the dosage of the drug is selected only by a doctor!).
Violation of fetal growth may be associated with, which indicates the need for a woman to be examined for infections, including sexually transmitted infections, and their rational therapy within the allowed time frame.
(Down syndrome, Edwards, Patau) - require additional consultation with a geneticist, the delivery of genetic markers, the study of the chromosome set of the fetus (karyotyping). For this, together with ultrasound, it is carried out (determination of alpha-fetoprotein, hCG, PAPP-A, SP-1, protein S-100). In case of deviation in ultrasound and biochemical parameters woman is offered:
(puncture of the (amniotic) membrane with amniotic fluid sampling for further research), optimal time for which 16-20 weeks,
(obtaining cord blood and its study),

important These examination methods make it possible to establish the exact chromosome set of the fetus and its sex. However, it should be remembered that they are produced only with informed consent pregnant, and every woman has the right to refuse them!

With serious genetic abnormalities Pregnancy is usually spontaneously terminated in the early stages. The occurrence of abnormalities in the development of the fetus contribute to:

Pathology of the internal organs of a woman(diseases of the heart, thyroid gland), although they usually cause disturbances in more late dates pregnancy.
Inferiority of the mucous membrane of the uterine cavity after abortion, in the presence of uterine fibroids, which does not allow fertilized egg normally implant and grow, which often leads to spontaneous abortion.

Thus, the KTP is important indicator, allowing to establish or clarify the gestational age, and its deviation from the norm should alert the doctor.

What will KTR tell about?

Gestational age and KTR

It is not uncommon for women to have menstrual irregularities. Then the obstetric term for determining pregnancy may be erroneous. Nevertheless, it is the KTR of the fetus that can clarify the exact figure. If menstrual cycle did not have any significant failures, with the help of ultrasound diagnostics, the doctor will only compare the indicators with each other. Despite the above figures, based on the extremely rapid development embryo, the error in determining the gestational age can be up to four days, both in the direction of increase and decrease.

KTP measurement technique

The ideal time for measuring the CTE of the fetus is its 11th week of development. After the 16-week period, these indicators will no longer have any meaning, since the development of the baby will be monitored on the basis of completely different indicators.

The coccygeal-parietal size is measured during the sagittal scan. In other words, the fetus is divided into two conditional symmetrical halves, and the measurement line runs from the crown to the coccyx, as indicated in the photo. In the presence of intensive movements of the baby, the doctor will necessary calculations after fixation of maximum extension of the small body.

The indicators taken using ultrasound are deciphered using a special table. This table contains fetal CTE values strictly by week of the first trimester, which includes the period from 7 to 14 weeks of gestation. The proposed table of fetal KTR by week in the first column, indicated by the indicator "50 percentile", represents the average value by week. In turn, the indicated values in the first column or "50th percentile" indicate the minimum value, and in the last or "95th percentile" the maximum allowable value. In any case, they are not pathological and are considered normal.

It is necessary to point out the fact that the table is intended for the doctor, and any transcripts must be carried out only with him in order to avoid misinterpretations.

Week 12 - a significant period for mom

After 12 obstetric weeks the first scheduled ultrasound examination is carried out, which is accompanied by a printout of a photo of the baby. During this period, at week 12, the length of the nasal bone of the baby is within 3 mm. Until the last 14 weeks of the survey, it will change significantly. 12 weeks of pregnancy is a unique period of fetal development. In addition to the fact that the expectant mother ceases to suffer from toxicosis, the brain structure of the baby improves, enters a period of active action hormonal system in terms of the work of the hypothalamic-pituitary structure.

The kidneys fill with urine, which is excreted into the amniotic space, the intestine conducts the first single, but already coordinated contractions of its muscle walls, and after 13 weeks, starting from 11, peristaltic waves will clearly appear. 12 weeks is also characterized by a different developmental norm - the cartilage is replaced bone tissue, forming ossifications of the fetal skeleton. This can also be seen in the photo. Not at the 11th or 13th week of life, but exactly at the 12th, the fingers get rid of the membranes, and at the 13th week, the flexion movements of the hands and the first attempts to move appear.

After 12 weeks, the KTR of the fetus is 5.3 cm. If at 11 weeks the baby’s growth was 1 mm per day, then at 13-14, from the moment of conception, he will already overcome the growth line of 2 mm. In this case, the uterus is already 9 cm wide and 12 cm long. Lying on her back, due to the pubic articulation, the expectant mother can feel her edge (this is the norm).

IN Lately more and more gynecologists are of the opinion that it is at week 11 that the first ultrasound examination is necessary. Why 11? This period is considered optimal for detecting severe defects that are not amenable to good diagnosis at the later stages of the baby's development: 13-14 weeks. At week 11, the gestational age from the moment of conception is better determined. As a rule, gynecology considers two terms: obstetric, which is counted from the moment of the last menstruation, and the period established by the KTR of the fetus, which is written next to it in brackets. Today, this is already the norm, as well as a photo of the examination of the fetus. After 12 weeks, the expectant mother must register at the antenatal clinic in order to receive a one-time special allowance for women for early term pregnancy.

What will KTR tell about?

With an increase in the gestational age by 11, 12, 13, 14 weeks, the coccygeal-parietal size also tends to become more high rate. In this case, this is the norm. The determination of these parameters provides an opportunity to track, in an indirect form, the course of pregnancy from the moment of conception. That is why in the first trimester, ultrasound is prescribed several times, and each session is accompanied by a photo printout. The size of the baby is important, indicating the dynamics of its development.

A rapid increase in the CTE of the fetus is not a pathology - this is an acceptable norm, which indicates the expected weight of the baby up to 4 kg, which is also recorded in the photo during an ultrasound session. Knowing about such a reaction, the abuse of drugs (multivitamins, actovegin) of metabolic action is prohibited in order to avoid the birth of a “hero”, the output of which will be provided by a caesarean section.

Despite the fact that the weight of a baby of 4 kg or more is the norm, this also happens - the baby will not come out on its own through the birth canals. To avoid injury to the baby, the loss of a woman in labor, it is better to insist on surgical intervention, or doctors themselves must offer such a method for the appearance of a child.

In generic practice, it is also possible that the size of the fetus at 13 and 14 weeks decreases in terms. In other words, the CTE of the fetus deviates to a smaller side, which is clearly recorded in the photo, and the norm, even an approximate one, is no longer displayed. In this case, the following options are possible:

obstetric term is not correct. At late ovulation fertilization could also occur much later. Such an option is possible. Then, after even 14 weeks, the size of the baby will be acceptable, but different. To confirm the version, a secondary examination is scheduled after 7-10 days, which should determine the correctness of the dynamics;
non-developing pregnancy or death of the embryo / fetus. If, after such a long period from the moment of conception, heart contractions or motor activity are not observed, it is necessary to scrape the uterine cavity with complete removal fetus. Delay in the provision of medical care is fraught with infertility, or a threat to life for a pregnant woman;
hormonal deficiency (mainly progesterone). It is fraught with premature termination of pregnancy. The doctor may prescribe the appropriate drugs: Utrozhestan, Duphaston.
infectious factor. It also affects the size of the baby from the moment of conception. It is eliminated by rational therapy within the allowed time.