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Accordingly, in creating recommendations and the associated summary table, single-point cutoffs were chosen based on expert review. American College of Obstetricians and Gynecologists. 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.
Because decisions to change the EDD significantly affect pregnancy management, their implications should be discussed with patients and recorded in the medical record. Subsequent changes to the EDD should be reserved for rare circumstances, 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. Appropriately performed obstetric ultrasonography has been shown to accurately determine fetal gestational age 1. 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.
The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. J Womens Health Larchmt ; 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.
Overall, a high-quality ultrasound in a woman's first trimester is the most accurate method of establishing or confirming the gestational age of the fetus.
When determined from the methods outlined in this document for estimating the due date, gestational age at delivery represents the best obstetric estimate for the purpose of clinical care and should be recorded on the birth certificate. Accurate dating of pregnancy is important to improve outcomes and is a research and public health imperative.
Ultrasound Obstet Gynecol ; 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.
Int J Gynaecol Obstet ; Inhowever, ACOG Weed smoker dating app what it means for a woman to carry her baby to termin an effort to prevent non-medically necessary inductions before 39 weeks.
However, Monday's joint statement Ultrasound dating discrepancies the various medical groups emphasizes that a woman's due date should rarely be changed based on an ultrasound in her second or third trimester -- particularly if she had a previous ultrasound that closely matched the estimate generated according to her last menstrual period.
A consistent and exacting approach to accurate dating is also a research and public health imperative because of the influence of dating on investigational protocols and vital statistics.
J Clin Ultrasound ; First- vs second-trimester ultrasound: A Cochrane review concluded that ultrasonography can reduce the need for postterm induction and lead to earlier detection of multiple gestations 6. Date changes for smaller discrepancies 10—14 days are appropriate based on how early in this second-trimester range the ultrasound examination was performed and on clinician assessment of LMP reliability.
It has been reported that approximately one half of women accurately recall their LMP 2—4. 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.
Yet even with improved imaging and dating policies, estimated due dates are just that -- estimates.
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