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  • 05.01.2019
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Methods for Estimating the Due Date - ACOG

Introduction to Transvaginal Ultrasound Scanning-Part II

Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. LMP vs. Overall, Problems with the accuracy of gestational age computed by last menstrual period LMP on birth certificates have been documented. However, because timing of ovulation varies, even with accurate recall and data entry of the LMP, estimates of gestational age based on LMP can be inaccurate. However, while early ultrasound has been established clinically as the gold standard, questions have been raised as to its validity for use in research.

Author manuscript; available in PMC Sep 1. PMID: Wrightc and Robert L. Goldenberg d. Elizabeth M. Linda L. Robert L.

Am J Obstet Gynecol. Dec;(6) Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination.

Copyright notice. The publisher's final edited version of this article is available at Int J Gynaecol Obstet.

To compare the accuracy of different pregnancy dating methods. comparison of 2 ultrasound policies involving consecutive low-risk women in a Five dating methods: LMP, FH, US and their combinations, were assessed Additional scans were permitted, as per current policy, only for specified clinical indications. We used ultrasound to scan nonselected singleton pregnancies at completed weeks. Regression models using a combination of any two or three ultrasonic Studies comparing LMP to ultrasound dating have been typically Women were eligible if their LMP indicated gestation. To compare the accuracy of the reported date of the last menstrual period (LMP) In addition, women often seek prenatal care late in pregnancy, which further .. dating by last menstrual period, ultrasound scanning and their combination.

See other articles in PMC that cite the published article. Abstract Objective To compare the accuracy of the reported date of the last menstrual period LMP with that of symphysis-fundal height SFH in the estimation of gestational age GAusing an ultrasound US scan as reference. Methods Gestational age was concurrently assessed by the 3 methods in this prospective, population-based, pregnancy-outcome study conducted in Hyderabad, Pakistan, from June 18,through August 31,with women between 20 and 26 weeks of a singleton pregnancy.

Introduction Knowing gestational age GA accurately is essential for optimal prenatal, delivery, and postnatal care.

Material and methods This prospective, population-based cohort study was conducted in 4 administrative units in Hyderabad, Pakistan. Results Of women screened between 20 and 26 weeks of pregnancy from June 18, through August 31,had singleton pregnancies.

Table 1 Characteristics of the study women a. Characteristics Value Age, y Open in a separate window. Table 2 Gestational age at enrollment 206 wk by the 3 methods, and mean differences between the tested methods and the reference method.

Method No. Table 3 Precision of the predicted date of delivery by each method a. Discussion Ultrasound equipment is not always available in low-resource countries and alternate methods such as LMP and SFH are used to determine GA and predict the date of delivery.

Synopsis Symphysis-fundal height was found to be more accurate than the reported last menstrual period in the estimation of gestational age in the absence of ultrasound equipment.

Footnotes Conflict of interest The authors declare that they have no conflict of interest. References 1. Last menstrual period provides the best estimates of gestation length for women in rural Guatemala. Paediatr Perinat Epidemiol. Discordance between LMP-based and clinically estimated gestational age: implication for research, programs, and policy.

General Obstetrics and Gynecology Obstetrics. Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. gestational ages with the use of LMP and ultrasound scan- or their combination were compared among women who attended prenatal care clinics in central. Dating gestational age by last menstrual period, symphysis-fundal height, and ultrasound in urban Pakistan. height (SFH) in the estimation of gestational age (GA), using an ultrasound (US) scan as reference. . Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. DavidA.

Public Health Rep. Sonographic determination of gestational age. Ultrasound Rev Obstet Gynecol.

Comparison of pregnancy dating by last menstrual period ultrasound scanning and their combination

Estimating the date of confinement: ultrasonographic biometry versus certain menstrual dates. Am J Obstet Gynecol. Early ultrasound dating of pregnancy: selection and measurement biases. J Clin Epidemiol.

Should all pregnant women have an ultrasound examination? Ultrasound Obstet Gynecol. The validity of gestational age estimation by menstrual dating in term, preterm, and postterm gestations.

Predicting Delivery Date by Ultrasound and Last Menstrual Period in Early Gestation

Comparison of pregnancy dating by last menstrual period, ultrasound scanning and their combination. Sayers S, Powers J. An Evaluation of three methods used to assess the gestational age of Aboriginal neonates. J Paediatr hild Health. Diagnosis of intrauterine growth retardation by a simple clinic method: measurement of uterine height. Mongelli M, Gardosi J.

Sympysis-fundus height and pregnancy characteristic in ultrasound-dated pregnancies. Obstet Gynecol. Gardosi J, Francis A. Controlled trial of fundal height measurement plotted on customized antenatal growth charts. Ogunranti J. Fundal height in normal pregnant Nigerian women: anthropometric gravidogram.

Int J Gynecol Obstet. Andersson R, Bergstrom S. Use of fundal height as a proxy for length of gestation in rural Africa.

Gestational Age Determination by Ultrasound

J Trop Med Hyg. Symphasis Fundal Height curve: a simple method for fetal growth assessment. J Postgrad Med.

ABSTRACT: Accurate dating of pregnancy is important to improve outcomes and is a As soon as data from the last menstrual period, the first accurate ultrasound to receive routine first-trimester ultrasonography compared with women who . dating by last menstrual period, ultrasound scanning, and their combination. To compare the accuracy of the reported date of the last menstrual period 2 The error margin of EDD estimated by ultrasound scan increases as the pregnancy advances, . or have poor recollection of her last menstrual period, then the application of . For preterm birth prediction, this combination of covariates correctly. Summary Although early ultrasound (gestation) systematically For gestational ages 2027 and 2831 weeks, the LMP?based birthweight 28?day menstrual cycle and ovulate 14 days after the first day of their LMP. . using the ultrasound?based estimate of gestational age on the date the.

Screening for light for gestational age infants: a comparison of 3 simple measurement. Limpanyalert P, Manotaya S. However, while early ultrasound has been established clinically as the gold standard, questions have been raised as to its validity for use in research.

One common concern is that ultrasound may introduce biases because it is based on fetal growth, and thus could systematically result in the assignment of incorrect lower gestational age estimates for smaller infants.

We sought to better understand and characterise the misclassification found with gestational age estimated by using LMP from birth certificates.

Unlike previous studies, this inquiry benefited from a large sample derived from the cohort of women who delivered in California in Failure to link records may have resulted from data entry errors, pregnancies that did not end in a livebirth, or women who moved out of State before delivery. We compared the mean birthweight and whether the infant was placed in a neonatal intensive care unit NICU for estimates that were concordant and discordant for gestational age.

All demographic characteristics were entered into a logistic regression model to assess the independent effects of each risk factor on inconsistent estimates, holding the other characteristics constant.

Women's Health Care Physicians

Using ultrasound as the gold standard, the overall sensitivity the percentage of true preterm deliveries correctly identified by LMP was Whereas whites had similar sensitivity and positive predictive value, Hispanics and African Americans had lower positive predictive value than sensitivity, meaning that the number of infants falsely identified as preterm using LMP estimates exceeded the number of true preterm infants missed by these estimates.

Among discordant gestational age groups, mean birthweights categorised by ultrasound were closer to the mean birthweights of infants with concordant estimates than those categorised by LMP. Examination of percentage of infants in the NICU showed that ultrasound estimates of gestational age were more consistent with what would be expected. Preterm gestational age groups determined by ultrasound had a higher percentage of infants in the NICU than did those determined by LMP.

Women who, according to birth certificate records, entered into prenatal care in the third or fourth month of pregnancy had infants with higher rates of inconsistent estimates compared with women who entered in the first or second month.

A similar pattern was found for education. The OR of 1.

We found a greater percentage of false preterm infants, resulting in inflation of the preterm delivery rate. The same pattern was found for women with less education. Some types of error, such as delayed ovulation, result in overestimation of gestational age, whereas poor recall could cause error in either direction.

With LMP, it is likely that more than one type of error is affecting the estimate of gestational age and contributing to bidirectional misclassification. Our study benefited from a large sample size that included a subpopulation of women from the cohort who gave birth in California in While this study population may be more representative and have more statistical power than those based on hospital or clinic samples, 9121318 characteristics of women included in our sample differed from those not included in several important ways.

If so, the misclassification rate of gestational age from LMP could be lower in the general population than found in this study. Obstetrics: A Short Textbook. Controlled trial of fundal height measurement plotted on customised antenatal growth charts. Symphysis-fundus height and pregnancy characteristics in ultrasound-dated pregnancies.

Max MongelliJason O Gardosi. Estimating the date of confinement: ultrasonographic biometry versus certain menstrual dates. Max MongelliMavourneen K. WilcoxJason O Gardosi.

Discordance between LMP-based and clinically estimated gestational age: implications for research, programs, and policy. Greg R. AlexanderMark E. TompkinsDeborah J. PetersenThomas C.

Samujinn

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