The American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal—Fetal Medicine recognize the advantages of a single dating paradigm being used within and between institutions that provide obstetric care. This Committee Opinion outlines a standardized approach to estimate gestational age and the anticipated due date. For instance, the EDD for a pregnancy that resulted from in vitro fertilization should be assigned using the age of the embryo and the date of transfer. First trimester ultrasound screening is effective in reducing postterm labor induction rates: Clinical Considerations in the Second Trimester Using a single ultrasound examination in the second trimester to assist in determining the gestational age enables simultaneous fetal anatomic evaluation. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Introduction An accurately assigned EDD early in prenatal care is among the most important results of evaluation and history taking. Underestimation of gestational age by conventional crown—rump length dating curves. J Womens Health Larchmt ; Accuracy of gestational age estimation by means of fetal crown—rump length measurement. Recommendations The American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal—Fetal Medicine make the following recommendations regarding the method for estimating gestational age and due date:
Am J Obstet Gynecol ; 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. Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. For the purposes of research and surveillance, the best obstetric estimate, rather than estimates based on the LMP alone, should be used as the measure for gestational age. J Womens Health Larchmt ; Estimation of gestational age by transvaginal sonographic measurement of greatest embryonic length in dated human embryos. Accuracy of gestational age estimation by means of fetal crown—rump length measurement. Mean sac diameter measurements are not recommended for estimating the due date. Cochrane Database of Systematic Reviews , Issue 7. Int J Gynaecol Obstet ; Accurate determination of gestational age can positively affect pregnancy outcomes. For instance, the EDD for a pregnancy that resulted from in vitro fertilization should be assigned using the age of the embryo and the date of transfer. Fetal Imaging Workshop Invited Participants. New crown—rump length curve based on over pregnancies. This Committee Opinion outlines a standardized approach to estimate gestational age and the anticipated due date. Ultrasound Obstet Gynecol ; 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. Subsequent changes to the EDD should be reserved for rare circumstances, discussed with the patient, and documented clearly in the medical record. Dating changes for smaller discrepancies are appropriate based on how early in the first trimester the ultrasound examination was performed and clinical assessment of the reliability of the LMP date Table 1. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. Accurate dating of pregnancy is important to improve outcomes and is a research and public health imperative. With rare exception, if a first-trimester ultrasound examination was performed, especially one consistent with LMP dating, gestational age should not be adjusted based on a second-trimester ultrasound examination. Likewise, the EDD for a day-3 embryo would be days from the embryo replacement date. For the purposes of research and surveillance, the best obstetric estimate, rather than estimates based on the last menstrual period alone, should be used as the measure for gestational age. Conclusion Accurate dating of pregnancy is important to improve outcomes and is a research and public health imperative. Goldberg, MD; and Yasser Y. American College of Obstetricians and Gynecologists.
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