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Determination of gestational age by ultrasound.
Author information: Comment in J Obstet Gynaecol Can. J Obstet Gynaecol Can. To assist clinicians in assigning gestational age based on ultrasound biometry. To determine whether ultrasound dating provides more accurate gestational age assessment than menstrual dating with or without the use of ultrasound. To provide maternity health care providers and researchers with evidence-based guidelines for the assignment of gestational age.
To determine which ultrasound biometric parameters are superior when gestational age is uncertain. To determine whether ultrasound gestational age assessment is cost effective. There were no date restrictions. Searches were updated on a regular basis and incorporated in the guideline to July 31, Grey unpublished literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.
The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care Table 1. Accurate assignment of gestational age may reduce post-dates labour induction and may improve obstetric care through allowing the optimal timing of necessary interventions and the avoidance of unnecessary ones. More accurate dating allows for optimal performance of prenatal screening tests for aneuploidy. A national algorithm for the assignment of gestational age may reduce practice variations across Canada for clinicians and researchers.
Potential harms include the possible reassignment of dates when significant fetal pathology such as fetal growth restriction or macrosomia result in a discrepancy between ultrasound biometric and clinical gestational age. Such reassignment may lead to the omission of appropriate-or the performance of inappropriate-fetal interventions.
Summary Statements 1. In the absence of better assessment of gestational age, routine ultrasound in the first or second trimester reduces inductions for post-term pregnancies. Ideally, every pregnant woman should be offered a first-trimester dating ultrasound; however, if the availability of obstetrical ultrasound is limited, it is reasonable to use a second-trimester scan to assess gestational age.
Notwithstanding Summary Statements 1, 2, and 3, women vary greatly in their awareness of their internal functions, including ovulation, and this self-knowledge can sometimes be very accurate. III Recommendations 1. First-trimester crown-rump length is the best parameter for determining gestational age and should be used whenever appropriate. I-A 2. If there is more than one first-trimester scan with a mean sac diameter or crown-rump length measurement, the earliest ultrasound with a crown-rump length equivalent to at least 7 weeks or 10 mm should be used to determine the gestational age.
III-B 3. Between the 12th and 14th weeks, crown-rump length and biparietal diameter are similar in accuracy. II-1A 4. Although transvaginal ultrasound may better visualize early embryonic structures than a transabdominal approach, it is not more accurate in determining gestational age. Crown-rump length measurement from either transabdominal or transvaginal ultrasound may be used to determine gestational age. II-1C 5. If a second- or third-trimester scan is used to determine gestational age, a combination of multiple biometric parameters biparietal diameter, head circumference, abdominal circumference, and femur length should be used to determine gestational age, rather than a single parameter.
II-1A 6. When the assignment of gestational age is based on a third-trimester ultrasound, it is difficult to confirm an accurate due date. Follow-up of interval growth is suggested 2 to 3 weeks following the ultrasound. III Recommandations 1.
Palmer, Philip E. S, Breyer, B, Bruguera, C. A, Gharbi, H. A, Goldberg, B. B. et al. ( ) . Manuel d' échographie / sous la direction de P. E. S. Palmer. Genève. Manuel d' échographie / sous la direction de P. E. S. Palmer gregstephensmusic.com accessioned, TZ. gregstephensmusic.comble, TZ. gregstephensmusic.com
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History of the developments of Ultrasound in Obstetrics and Gynecology This is must-read for medical professionals and history buffs News and Views on the latest in Ultrasound scans in pregnancy from the major News sources on the Internet And take a look at Great reading and helpful information on Obstetric Ultrasound:
Our aim was to evaluate the accuracy of estimated fetal weight EFW by ultrasound at due date and the factors that could affect it. The mean absolute percentage error was 7. Obesity in early pregnancy or childbirth, excessive weight gain, the presence of oligoanamnios and fetal macrosomia had no influence on the estimated fetal weight.
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Determination of gestational age by ultrasound.
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