Because this practice assumes a regular menstrual cycle of 28 days, with ovulation occurring on the 14th day after the beginning of the menstrual cycle, this practice does not account for inaccurate recall of the LMP, irregularities in cycle length, or variability in the timing of ovulation. A Cochrane review concluded that ultrasonography can reduce the need for postterm induction and lead to earlier detection of multiple gestations 6. New charts for ultrasound dating of pregnancy and assessment of fetal growth: Babies have their own clock and can come anywhere from three weeks before this exquisitely determined due date till two weeks after. Accurate determination of gestational age can positively affect pregnancy outcomes. Appropriately performed obstetric ultrasonography has been shown to accurately determine fetal gestational age 1. In the second trimester, past the first 12 weeks , the other measurements can be added. Table 1 provides guidelines for estimating the due date based on ultrasonography and the LMP in pregnancy, and provides single-point cutoffs and ranges based on available evidence and expert opinion. Measurements of the CRL are more accurate the earlier in the first trimester that ultrasonography is performed 11, 15— No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. The state covers a land area of approximately 8, As soon as data from the last menstrual period, the first accurate ultrasound examination, or both are obtained, the gestational age and the estimated due date EDD should be determined, discussed with the patient, and documented clearly in the medical record.
In clinical practice, the gestational age and EDD are often determined using the LMP, except when the discrepancy between the LMP-derived gestational age or EDD and that of early pregnancy ultrasound scan exceeds 1 week; in this situation, the ultrasound scan estimates are more reliable and should be used. First- vs second-trimester ultrasound: Because of the risk of redating a small fetus that may be growth restricted, management decisions based on third-trimester ultrasonography alone are especially problematic; therefore, decisions need to be guided by careful consideration of the entire clinical picture and may require close surveillance, including repeat ultrasonography, to ensure appropriate interval growth. As soon as data from the last menstrual period LMP , the first accurate ultrasound examination, or both are obtained, the gestational age and the EDD should be determined, discussed with the patient, and documented clearly in the medical record. The last menstrual period LMP was considered certain in 13, and uncertain in cases. With transvaginal ultrasound, checking for embryonic development known to occur within a certain time frame more accurately dates a pregnancy. A scenario is often created where the attending medical practitioner feels the pregnancy is prolonged based on a certain LMP-derived EDD while the client holds a different view based on her ultrasound scan-derived EDD, and therefore refuses to accept induction of labor despite counseling. New crown—rump length curve based on over pregnancies. Table 1 provides guidelines for estimating the due date based on ultrasonography and the LMP in pregnancy, and provides single-point cutoffs and ranges based on available evidence and expert opinion. This information is vital for timing of appropriate obstetric care; scheduling and interpretation of certain antepartum tests; determining the appropriateness of fetal growth; and designing interventions to prevent preterm births, postterm births, and related morbidities. American College of Obstetricians and Gynecologists. The commonest indication for induction of labor in the two hospitals and in our environment is prolonged pregnancy. Both centers provide antenatal and postnatal care services to pregnant women in Enugu State. At all gestational ages, ultrasound was superior to certain LMP in predicting the day of delivery by at least 1. This scenario is a big challenge in terms of prevention of prolonged pregnancy in our environment where women register late for antenatal care 9 and rarely have reliable early ultrasound scan results. The mean age of the respondents was When ultrasound was used instead of certain LMP, the number of postterm pregnancies decreased from After that time, BPD at least 21 mm showed a similar error 7. Results The mean age of the women was I want to know if I should trust the accuracy on an ultrasound to date a pregnancy. Ultrasound was more accurate than LMP in dating, and when it was used the number of postterm pregnancies decreased. Cochrane Database of Systematic Reviews , Issue 7. Accordingly, in creating recommendations and the associated summary table, single-point cutoffs were chosen based on expert review. Fetal Imaging Workshop Invited Participants. Click here for additional information. Babies have their own clock and can come anywhere from three weeks before this exquisitely determined due date till two weeks after. A P-value of less than 0.
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