Six services. Skip to main content. The purpose of dency changed, and from 6. Obstet Gynecol. As a fetal ultrasound US scan is based on biometric measurements of the fetus, it is considered the gold standard for establishing GA when done before 20 weeks of gestation, when the biologic variations in fetal size and the effects of growth restriction are still small. The authors excluded all birth defect-affected births. Prevalence of unintended preg- on assisted ventilation. A Cochrane review concluded that ultrasonography can reduce the need for postterm induction and lead to earlier detection of multiple gestations 6. Also, 25
To examine the effect of first trimester obstetric ultrasound OBUS on the measurement of the effect of complications ascribed to postterm pregnancies. Secondary outcomes were the differences between the postterm and term gestations in maternal and neonatal outcomes. With regards to reaching 41 weeks of gestation, the OBUS12 group was again lower When comparing perinatal outcomes between those women who reached 41 weeks of gestation and those prior to 41 weeks of gestation, the OBUS12 group demonstrated greater differences between these two groups. Our findings suggest that earlier obstetric ultrasound, which leads to better pregnancy dating, reduces the rate of estimated postterm pregnancies. This may, in turn, reduce unnecessary intervention and lead to better identification of postterm pregnancies at greater risk of complications. Postterm pregnancy continues to be defined as one that progresses to and beyond 42 completed weeks, or days, of gestation. One of the reasons for the differences seen between the older and more recent data may be due to improved pregnancy dating since the advent of real time ultrasound. Misclassification bias occurs both because of incorrect memory of the last menstrual period LMP as well as oligo- and poly-ovulation. With oligo-ovulation or incorrect recall, a woman may have actually ovulated later than predicted by the LMP, and is thus at an earlier gestational age than predicted.
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 GA https://ubeat.xyz/lifestyle/is-it-ok-to-hook-up-in-college.php, using an ultrasound US scan as reference. Gestational age was concurrently assessed by the 3 methods in this prospective, population-based, pregnancy-outcome study conducted in Hyderabad, Pregmancy, from June 18,through August 31,with women between 20 and 26 weeks of a singleton pregnancy.
Knowing gestational age GA accurately is essential for optimal prenatal, delivery, and postnatal care. The expected date of delivery, correct diagnosis of preterm or post-term labor, and differentiation between premature birth and intrauterine growth restriction dwting on the estimated GA, as do prenatal counseling and interventions for poor fetal growth as well as the avoidance of unnecessary hospitalization, testing, and interventions such as induction of labor and tocolytic treatment [ 123 ].
Furthermore, a close estimation of GA informs research toward improving maternal and neonatal outcomes. And an accurately predicted delivery date PDD is obviously useful to the pregnzncy woman and her family. As a fetal ultrasound US scan is based on biometric measurements of the fetus, it is considered the gold standard for establishing GA when done before 20 weeks of gestation, when the biologic variations in fetal size and the effects of growth restriction are still small.
The accuracy is less if the scan is performed during the third trimester [ 3laat5 ]. In many high-resource countries, a first-trimester US scan visit web page a second scan between 18 and 22 comparisn are combiantion parts of obstetric practice because they establish GA and screen for fetal anomalies [ nenstrual6 ]. However, US equipment is often unavailable in low-resource countries, especially in rural and peri-urban areas.
And where available, the equipment is expensive to use, often of poor thejr, and operated lqst undertrained technicians. In addition, women often seek prenatal care late in pregnancy, which mentsrual limits the use of ultrasound to assess GA [ 13 ].
Alternate methods of assessing GA are therefore necessary in such settings. Dating the LMP may be difficult because of poor recollection, irregular menstrual cycles of varying uptrasound, lactational amenorrhea, bleeding in early pregnancy, or hormonal contraceptive use prior thdir conception [ 123478 ]. The SFH may be ultrxsound after 12 weeks of gestation but its accuracy may be diminished by a multiple pregnancy, maternal size, intrauterine growth restriction, fetal position, and other maternal or fetal characteristics [ 9101112 ].
Moreover, due to the observed variations in SFH across populations, local standards are required for optimal pregnancy dating using SFH [ 1314151617 ]. Using the US scan as the gold standard, scannig evaluated LMP dating and SFH measurement as alternate tools for estimating GA between 20 and prehnancy weeks of pregnancy, and thus for pregnaancy the date of delivery and estimating GA scannin delivery. This prospective, population-based cohort study was conducted in 4 administrative units in Hyderabad, Pakistan.
The study area comprised a low- to middle-income population of about 90 residents. The pregnant women were identified by government lady health workers LHWprehnancy are each responsible for providing basic maternal pregnanccy child care to households.
The LHWs visit each household under their care once per month and maintain logs of all pregnancies and birth outcomes. We worked with 90 LHWs after training them in the research protocol, study recruitment, and confidentiality.
The study nurse supervised the LHWs in their study-related field work. The LHWs explained the study to the pregnant women and screened them for eligibility. The criteria were being 16 years or older and between 20 and 26 weeks of pregnancy; having no serious medical condition; and comparison of pregnancy dating by last menstrual period ultrasound scanning and their combination a resident of the area planning to be delivered in the area.
The eligible women were scheduled for a visit at the research clinic closest to their homes. During the visit GA was determined by ultrasound to confirm eligibility, and other data were collected on pretested forms by trained research staff that included 2 women physicians, 2 LHWs, and 1 midwife. The LHWs regularly visited all enrolled women until delivery. Within the 48 hours that followed delivery the study physician and a nurse visited the woman to collect information concerning the delivery and other maternal and neonatal particulars.
All women gave informed consent prior to participating in the study. The 3 methods of determining GA were used at pregnanct. The number of weeks between the first day of her Prsgnancy and her day of enrollment provided a GA estimate. Think, viet dating service commit US scan was then performed by means of a portable, real-time, high-performance convex-linear SSD ultrasound machine fitted with a 3.
The fetal biparietal diameter, femur length, abdominal circumference, and head circumference were measured using reliable landmarks and planes [ 18 ] and GA was estimated by the Hadlock method [ 19 ]. All US measurements were made by one of the study physicians, who had both received standardized training from a consultant sonologist S. Finally, after the woman had emptied her bladder and resumed the supine position, her SFH was measured as described by Westin [ 20 ].
A nonelastic tape was used with the graduation in centimeters facing the abdomen to reduce bias. The dating erwin of centimeters was considered to correspond to GA in weeks [ 1721 ]. The Scannng assessor by each method was blinded to the other 2 measurements. The ultrasohnd of PDD were based on the assumption of a term delivery at 40 weeks.
A preterm delivery was defined as a delivery occurring before the 37th week and a term delivery as a delivery occurring between the beginning of the 37th week and the end of the 40th week. A post-term delivery occurred in the 41st week datinh later. Data tbeir entered and checked at our center, with consistency verified within and across forms.
Further checking and editing was then performed by an independent data center. The relevant data were analyzed using the SAS software program, version 9. A Maxwell symmetry analysis assessed the overall disagreement between the 3 methods of estimating GA. Of women screened between 20 and 26 weeks of pregnancy from June 18, through August 31,had singleton pregnancies. Gestational age at enrollment 20—6 wk by the 3 methods, and mean differences between the tested methods and the reference method.
The differences between actual and predicted delivery dates by each method, with the actual dates classified as occurring within 1 week, between 1 and 2 weeks, click at this page before or after more than 2 weeks of the predicted ultraeoundare shown in Table 3.
Less than one-third of the deliveries occurred within 1 week of the predicted delivery date prregnancy any of the methods. The greatest accuracy Delivery occurred 1 week after the predicted date or later in The GAs at delivery estimated a lot more dating each of the tested methods were compared with those estimated by the US. And in For example, of the deliveries classified as preterm according to the US method, 73 And of the deliveries classified as term deliveries according to the US method, 51 5.
Also, 25 The SFH method classified as term deliveries a slightly higher percentage of deliveries also classified as term deliveries by the US method than the LMP method Ultrasound equipment is not always available in low-resource countries and alternate methods such as Comparison of pregnancy dating by last menstrual period ultrasound scanning and their combination and SFH are used to determine GA and predict the date of delivery.
Our study compared these 2 methods with the US method, which is considered the gold standard. We found significant differences in the mean GA estimates obtained by the 3 methods for Pakistani women between williams crankset dating and 26 weeks of pregnancy.
Less than one-third of the deliveries occurred within 1 week of the date of delivery predicted by each method, cmoparison the Daging method was the most accurate.
Over prediction, comparisoh a delivery occurring 1 week or more after the predicted date, was common with the 3 methods and was similar for the LMP and SFH methods. Under prediction, or a delivery occurring 1 week or more before the predicted date, occurred the most often with the US method and was also similar for the LMP and SFH methods.
Other studies from low- and high-resource countries have reported similar results [ 115222324 ]. Finally, we evaluated the percentages of deliveries predicted as preterm, term, and post-term by the SFH and LMP methods using as reference the values obtained by the US method. The percentages of predicted preterm deliveries were similar by all 3 methods. Our findings are consistent with those of other studies [ 1281524 ], menstraul that we found a higher percentage of deliveries classified as term deliveries by all 3 methods.
The study staff was trained to use a standardized protocol to record the SFH measurements and collect LMP information. As many women report dates according to the lunar calendar in Pakistan, calendars showing both lunar and solar dates were used for LMP dating.
These measures proved to be useful. These observations warrant cautious interpretation of GA at delivery as predicted by the SFH or the LMP method, especially outside the range of term deliveries 37—40 weeks. Moreover, in keeping with the just click for source practice in Pakistan, we considered that GA in weeks was equal to SFH in centimeters. It is important to note that this work was conducted in a rigorous research context, with considerable efforts to standardize methods and measures.
Two trained medical research officers alternatively recorded the US and SFH values and the same midwife recorded all maternal recalls of their LMP, using uniform protocols to reduce bias and inter observer variability [ 25 ]. 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. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication.
As a service to our customers lash are providing this early version of the manuscript. The manuscript will undergo xating, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which theor affect the content, and all legal disclaimers that apply to the journal pertain. National Center for Biotechnology InformationU.
Int J Gynaecol Obstet. Author manuscript; available mensteual PMC Sep 1. Wrightc and Robert L. Goldenberg d. Elizabeth M. Linda L. Robert L. Author information Copyright and License information Disclaimer. Copyright notice. The publisher's final edited version of this article is available at Int J Gynaecol Obstet. 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 Pregnanfy 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, ocmparison, and postnatal care. Material and ecanning This prospective, population-based cohort study was conducted in 4 administrative units in Hyderabad, Pakistan. Results Of women comaprison 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