Iranian Journal of Neonatology

Iranian Journal of Neonatology

Assessment of Neonatal Gestational Age by Ultrasonographic Transverse Cerebellar Diameter Measurement - A Prospective Cross-Sectional Study

Document Type : Original Article

Authors
Sachin Verma
Astha Pandey
Neeta Bhargava
Vaishali Upadhyaya
Department of Pediatrics, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow
10.22038/ijn.2025.85418.2638
Abstract
Background: Accurate assessment of gestational age (GA) is important for management and monitoring of neonates. Traditional GA in neonates is assessed mother's first day of last menstrual period (LMP) which can be inaccurate in case of irregular cycle and poor y. Fetal age assessment TCD well studied but studies in neonatal period. The emerging biometric parameter, transverse cerebellar diameter (TCD), offers advantages as it remains unaffected by conditions alter skull shape and antenatal growth fluctuations. Aim to evaluate the effectiveness of TCD measurement neonatal gestational age.
Methods: This prospective cross-sectional study included 112 neonates, spanning preterm and term infants, assessed within 72. Last Menstrual Period (LMP) was used to determine GA. TCD scans were conducted a GE LogiQ-V2 scanner and pediatric curvilinear probe.
Results: There was a statistically significant correlation (p < 0.0001) between TCD and gestational age. Linear regression analysis showed 0.4052 change in gestational age per unit change in TCD. Spearman correlation analysis show strong positive correlations between TCD and gestational age (r = 0.8786), weight (r = 0.8242) and length (r = 0.8526). A regression equation based on TCD predict neonatal gestational age. Additionally, TCD demonstrated a very strong positive correlation with asymmetric IUGR (r = 0.9161) but a weak positive correlation with symmetric IUGR in relation to gestational age (r = 0.4761). Notably, comparisons with other studies in diverse ethnic populations revealed significant differences in TCD findings.
Conclusion: Despite not directly indicating IUGR, TCD shows potential utility in estimating neonatal gestational age as it correlates significantly with advancing gestational a
 
Keywords
Gestational age
Intrauterine growth restriction
Neonate
Transverse cerebellar diameter
Ultrasonography 
  1. ten Donkelaar HJ, den Dunnen WF, Lammens M, Wesseling P, Willemsen M, Hori A. Development and developmental disorders of the human cerebellum. J Neurol. 2003;250(9):1025-1036.
  2. Budday S, Steinmann P, Kuhl E. Physical biology of human brain development. Front Cell Neurosci. 2015 Jul 8;9:257. 
  3. Allin M, Matsumoto H, Santhouse AM, Nosarti C, AlAsady MH, Stewart AL, et al. Cognitive and motor function and the size of the cerebellum in adolescents born very pre-term. Brain. 2001 Jan;124(Pt 1):60-66.
  4. Imamoglu EY, Gursoy T, Ovali F, Hayran M, Karatekin G. Nomograms of cerebellar vermis height and transverse cerebellar diameter in appropriate-for-gestational-age neonates. Early Hum Dev. 2013;89(12):919-923.
  5. Ballard JL, Khoury JC, Wedig KL, Wang L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991;119(3):417-423.
  6. Roy J, Sanyal P, Saboo V, Saha RG, KA S, Raj R, et al. Role of the Ratio of Trans Cerebellar Diameter
    and Abdominal Circumference in Detecting Asymmetrical Intra Uterine Growth Restriction. J evol med dent sci. 2019;23(30):3858-3863.
  7. Hata K, Hata T, Senoh D, Makihara K, Aoki S, Takamiya O, et al. Ultrasonographic measurement of the fetal transverse cerebellum in utero. Gynecol Obstet Invest. 1989;28(2):111-112. 
  8. Kramer MS, Ananth CV, Platt RW, Joseph KS. US Black vs White disparities in foetal growth: physiological or pathological? Int J Epidemiol. 2006;35(5):1187-1195
  9. Mishra S, Ghatak S, Singh P, Agrawal D, Garg P. Transverse cerebellar diameter: a reliable predictor of gestational age. Afr Health Sci. 2020;20(4):1927-1932.
  10. Mourya S, Mourya HK, Jain V, Verma M. Fetal transverse cerebellar diameter measurement in intrauterine growth restriction: a more accurate parameter for gestational age assessment at term. Int J Reprod Contracept Obstet Gynecol. 2019; 8(11):4391-4395.
  11. Hill LM, Guzick D, Rivello D, Hixson J, Peterson C. The transverse cerebellar diameter cannot be used to assess gestational age in the small for gestational age fetus. Obstet Gynecol. 1990;75(3 Pt 1):329-333.
  12. Benavente-Fernández I, Rodríguez-Zafra E, León-Martínez J, Jiménez-Gómez G, Ruiz-González E, Fernández-Colina RC, et al. Normal cerebellar growth by using three-dimensional us in the preterm infant from birth to term-corrected age. Radiology. 2018;288(1):254-261.
  13. Davies MW, Swaminathan M, Betheras FR. Measurement of the transverse cerebellar diameter in preterm neonates and its use in assessment of gestational age. Australas Radiol. 2001;45(3):309-312.
  14. da Graça AL, Cardoso KR, da Costa JM, Cowan FM. Assessment of gestational age using cerebellar measurements at cranial ultrasound: what is the best approach? Early Hum Dev. 2013;89(1):1-5. 
  15. Makhoul IR, Goldstein I, Epelman M, Tamir A, Reece EA, Sujov P. Neonatal transverse cerebellar diameter in normal and growth-restricted infants. J Matern Fetal Med. 2000;9(3):155-160.
  16. İmamoğlu EY, GürsoY T, SaNcak S, KaraTEKİ G. Does being an infant of gestational diabetic mother affect cerebellar size? Medeni. Med. J. 2016;31(1):32-36.
  17. Co E, Raju TN, Aldana O. Cerebellar dimensions in assessment of gestational age in neonates. Radiol. 1991:181(2):581-585.
  18. Lee W, Barton S, Comstock CH, Bajorek S, Batton D, Kirk JS. Transverse cerebellar diameter: a useful predictor of gestational age for fetuses with asymmetric growth retardation. Am J Obstet Gynecol. 1991;165(4 Pt 1):1044-1050.
  19. Chavez MR, Ananth CV, Kaminsky LM, et al.
    Fetal transcerebellar diameter measurement for prediction of gestational age in twins. Am J Obstet Gynecol. 2006;195(6):1596-1600.
  20. Vinkesteijn AS, Mulder PG, Wladimiroff JW. Fetal transverse cerebellar diameter measurements in normal and reduced fetal growth. Ultrasound Obstet Gynecol. 2000;15(1):47-51.
  21. Goel P, Singla M, Ghal R, Jain S, Budhiraja V, Babu CR. Transverse cerebellar diameter-a marker for estimation of gestational age. J Anat Soc India. 2010;59(2):158-161.
  22. Dashottar S, Senger KP, Shukla Y, Singh A, Sharma S. Transcerebellar diameter: an effective tool in predicting gestational age in normal and IUGR pregnancy. Int J Reprod Contracept Obstet Gynecol. 2018;7(10):4190-4197.
  23. Bansal M, Bansal A, Jain S, Khare S, Ghai R. A study of correlation of transverse cerebellar diameter with gestational age in the normal & growth restricted fetuses in Western Uttar Pradesh. People’s J Sci Res. 2014;7(2):16-21
  24. Goldstein I, Reece EA, Pilu G, Bovicelli L, Hobbins JC. Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development. Am J Obstet Gynecol. 1987;156(5):1065-1069..
  25. Mourya S, Mourya HK, Jain V, Verma M. Fetal transverse cerebellar diameter measurement in intrauterine growth restriction: a more accurate parameter for gestational age assessment at term. Int J Reprod Contracept Obstet Gynecol. 2019;8(11):4391-4395.
  26. Rizzo G, Capponi A, Pietrolucci ME, Capece A, Aiello E, Mammarella S, et al. An algorithm based on OmniView technology to reconstruct sagittal and coronal planes of the fetal brain from volume datasets acquired by three‐dimensional ultrasound. Ultrasound Obstet Gynecol. 2011;38(2):158-164.
  27. Basnet R, Manandhar SR, Phuyal R, Basnet R. 109 Ponderal index in low birth weight babies: BMJ Paediatrics Open 2021:5.

 

 

Iranian Journal of Neonatology
Volume 17, Issue 1
Winter 2026
Pages 27-33