Late dating scan accuracy
Such legislation should also discourage self-referral by pregnant women for ultrasound. This will further help to prevent our women from visiting poorly trained sonologists and guard against the possible effects of unreliable ultrasound scan results on maternal and neonatal health. Tertiary education was identified in this report as a strong determinant of acceptance of induction of labor for postdatism using the last menstrual date.
This may be explained by the expected impact of education on uptake of maternal and neonatal health services, as observed by previous authors. Also, the lesser educated are more likely to rely more on the impression created outside about a procedure like ultrasound, whether right or wrong. As pointed out by Olusanya et al, 12 the higher the educational status of the woman, the higher the social class, and this no doubt may explain the higher acceptance rate among women of higher social class than among women of lower social class.
This will help to reduce the incidence of prolonged pregnancy and its complications in our environment. The limitation of this study is that the willingness to accept labor induction was assumed to mean acceptance of induction of labor.
Methods for Estimating the Due Date
It is likely that some of the respondents might have responded differently if their pregnancies were actually prolonged. However, the effect of this limitation on the study estimates is likely to be minimal. Selection of respondents for this study was consecutive considering the short study period, and selection bias cannot be ruled out; a longer study period and use of probability sampling would have been more appropriate. The strength of the study is that it is a novel effort toward stimulating the interest of physicians involved in maternal care regarding the increasing wave of self-referral for ultrasound scan in pregnancy in our environment, and the strong value mothers attach to ultrasound scan dating.
In conclusion, this study shows that in cases where late pregnancy ultrasound scan-derived EDD is further on than the menstrual dating, most women seen in the antenatal clinics at the teaching hospitals in Enugu would not be willing to accept labor induction for postdatism based on their menstrual dating. This worrisome attachment to ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment.
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Predictors of this attitude in our study were low educational status, low social class, and poor knowledge of the limitations of late pregnancy ultrasound scan dating. Antenatal health education should discourage self-referral for ultrasound scanning and emphasize the limitations of late ultrasound scan dating as well as the perinatal effects of prolonged pregnancy.
Educational campaigns are also encouraged regarding the need for early antenatal booking and accurate determination of EDD and gestational age during pregnancy. National Center for Biotechnology Information , U. Int J Womens Health. Published online Feb Author information Copyright and License information Disclaimer.
The full terms of the License are available at http: Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Methods This cross-sectional study included consecutive pregnant women receiving antenatal care at two tertiary health institutions in Enugu, Nigeria, from January 1, to March 31, Results The mean age of the women was Conclusion The worrisome confidence in ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment.
Introduction Knowledge of the expected date of delivery EDD and gestational age is essential in the management of pregnant women. Materials and methods Study area Enugu State is one of the five states in the southeast geopolitical zone of Nigeria, and its capital city is Enugu. Study design and sample selection This was a cross-sectional study of consecutive pregnant women attending for antenatal care at the antenatal clinics of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, and the Enugu State University Teaching Hospital, Parklane, from January 1, to March 31, Results A total of questionnaires were administered, but only were completed correctly, giving a response rate of Table 1 Sociodemographic characteristics of respondents.
Open in a separate window. Table 2 Characteristics of respondents versus acceptance of labor induction for postdatism using menstrual dating. Discussion This study demonstrates that pregnant women in Enugu, Nigeria, have poor knowledge of the limits of accuracy of late pregnancy ultrasound scan in estimating the delivery date. Footnotes Disclosure The authors report no conflicts of interest in this work.
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Lynch CD, Zhang J. The research implications of the selection of a gestational age estimation method. Dating gestational age by last menstrual period, symphysis-fundal height, and ultrasound in urban Pakistan. Int J Gynecol Obstet. Issues in pregnancy dating: J Midwifery Womens Health. Tailpale P, Hiilesmaa V. Predicting delivery date by ultrasound and last menstrual period in early gestation.
Can your pregnancy scan give the wrong due date?
Prediction of delivery date by sonography in the first and second trimesters. Mongelli M, Ramus RM. Estimating the date of confinement: Am J Obstet Gynecol.
The influence of parity on the gestational age at booking among pregnant women in Enugu, South East Nigeria. Niger J Physio Sci. Utilization of insecticide treated nets among pregnant women in Enugu, South Eastern Nigeria. Niger J Clin Pract.
Membrane stripping to prevent post-term pregnancy in Enugu, Nigeria: June [Epub ahead of print. The importance of social class in voluntary fertility control in a developing country. West Afr J Med. Sonographic determination of gestational age. Ultrasound Rev Obstet Gynecol. Chantry AA, Lopez E. The best available data support adjusting the EDD of a pregnancy if the first ultrasonography in the pregnancy is performed in the third trimester and suggests a discrepancy in gestational dating of more than 21 days. As soon as data from the 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.
Methods for Estimating the Due Date - ACOG
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. 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. 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.
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. Methods for estimating the due date. American College of Obstetricians and Gynecologists.
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Women's Health Care Physicians. 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: 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.
Introduction An accurately assigned EDD early in prenatal care is among the most important results of evaluation and history taking.
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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. Ultrasonography dating in the second trimester typically is based on regression formulas that incorporate variables such as the biparietal diameter and head circumference measured in transverse section of the head at the level of the thalami and cavum septi pellucidi; the cerebellar hemispheres should not be visible in this scanning plane the femur length measured with full length of the bone perpendicular to the ultrasound beam, excluding the distal femoral epiphysis the abdominal circumference measured in symmetrical, transverse round section at the skin line, with visualization of the vertebrae and in a plane with visualization of the stomach, umbilical vein, and portal sinus 8 Other biometric variables, such as additional long bones and the transverse cerebellar diameter, also can play a role.
Conclusion Accurate dating of pregnancy is important to improve outcomes and is a research and public health imperative. Fetal Imaging Workshop Invited Participants. A comparison of recalled date of last menstrual period with prospectively recorded dates. J Womens Health Larchmt ; Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. Am J Obstet Gynecol ; Last menstrual period versus ultrasound for pregnancy dating. Int J Gynaecol Obstet ; First trimester ultrasound screening is effective in reducing postterm labor induction rates: Ultrasound for fetal assessment in early pregnancy.
Cochrane Database of Systematic Reviews , Issue 7. Predicting delivery date by ultrasound and last menstrual period in early gestation. New charts for ultrasound dating of pregnancy and assessment of fetal growth: Ultrasound Obstet Gynecol ; First- and second-trimester ultrasound assessment of gestational age. First- vs second-trimester ultrasound: Br J Obstet Gynaecol ; Gestational age in pregnancies conceived after in vitro fertilization: Ultrasound dating at 12—14 weeks of gestation.
A prospective cross-validation of established dating formulae in in-vitro fertilized pregnancies. Accuracy of gestational age estimation by means of fetal crown—rump length measurement.