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    Fess or Iful Lah: Gestationa L Estim Due Dates

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    Sanjay Kumar Sanju
    Accurate determination of gestational age (GA) and estimated due date (EDD) is important for prenatal care, testing, and delivery timing. While last menstrual period (LMP) is commonly used, ultrasound is more reliable. An early pregnancy ultrasound before 14 weeks that measures the crown-rump length is the most accurate method to confirm GA and establish EDD, with accuracy up to one day. If LMP and ultrasound dates differ by less than 7 days and periods are regular, LMP dates should be used, but ultrasound should override if the difference is greater. Physical exam and history can support GA estimation but are not as reliable as early ultrasound.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Fess or Iful Lah: Gestationa L Estim Due Dates

    Uploaded by

    Sanjay Kumar Sanju
    40 views21 pages
    Accurate determination of gestational age (GA) and estimated due date (EDD) is important for prenatal care, testing, and delivery timing. While last menstrual period (LMP) is commonly used, ultrasound is more reliable. An early pregnancy ultrasound before 14 weeks that measures the crown-rump length is the most accurate method to confirm GA and establish EDD, with accuracy up to one day. If LMP and ultrasound dates differ by less than 7 days and periods are regular, LMP dates should be used, but ultrasound should override if the difference is greater. Physical exam and history can support GA estimation but are not as reliable as early ultrasound.

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    Accurate determination of gestational age (GA) and estimated due date (EDD) is important for prenatal care, testing, and delivery timing. While last menstrual period (LMP) is commonly used, ultrasound is more reliable. An early pregnancy ultrasound before 14 weeks that measures the crown-rump length is the most accurate method to confirm GA and establish EDD, with accuracy up to one day. If LMP and ultrasound dates differ by less than 7 days and periods are regular, LMP dates should be used, but ultrasound should override if the difference is greater. Physical exam and history can support GA estimation but are not as reliable as early ultrasound.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    40 views21 pages

    Fess or Iful Lah: Gestationa L Estim Due Dates

    Uploaded by

    Sanjay Kumar Sanju
    Accurate determination of gestational age (GA) and estimated due date (EDD) is important for prenatal care, testing, and delivery timing. While last menstrual period (LMP) is commonly used, ultrasound is more reliable. An early pregnancy ultrasound before 14 weeks that measures the crown-rump length is the most accurate method to confirm GA and establish EDD, with accuracy up to one day. If LMP and ultrasound dates differ by less than 7 days and periods are regular, LMP dates should be used, but ultrasound should override if the difference is greater. Physical exam and history can support GA estimation but are not as reliable as early ultrasound.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 21

    D r

    s o r
    f e s n
    r o h a
    e P h K
    i a t l l a
    s o c i f u
    s n
    A Ha

    GESTA
    TIONAL
    AGE
    ESTIM
    ATION &
    OF D U E
    DATES

    1
    OBJECTIVE
    S
    • Importance of determination of
    gestational age
    • Definitions of important
    terminology
    • Methods of determination
    of gestational age
    • Proper estimation of GA &
    EDD
    2
    IMPORTANCE OF DETERMINATION OF
    GESTATIONAL AGE

    • Accurate determination of the


    D ue
    Expected (EDD) - one of the m ost
    im portant factors in early preg nancy
    Date
    assessment

    • Healthcare professionals must take great


    pains to determine accurate gestation &
    EDD during booking

    3
    Accurate dating is vital for

    • the timing of appropriate antenatal care


    • scheduling & interpretation of tests
    • determining appropriate fetal growth
    • intervention purposes
    prevention of preterm birth
    prevent postdates
    prevent comorbidities
    • for research purposes
    4
    Gestational age can be determined
    by

    Clinical History

    Physical Examination

    Ultrasound Scan

    5
    CLINICAL HISTORY

    6
    Naegele’s Rule:
    Determining the • E DD is 2 8 0 days from
    the LNMP
    gestational age • Must be regular cycles
    for this to be accurate
    using clinical history • Accuracy is up to 5 0 %
    within 7 days on either side

    • Reliant on knowledge Inaccurate in patients in the


    following circumstances:-
    of accurate • Oligomenorrhoea or
    polymenorrhagia (irregular
    menstrual period cycles)
    • Bleeding in the first trimester
    of pregnancy (implantation
    • 1st day of bleeding)
    • Pregnancy following the use
    LMP of oral contraceptives or
    • calculation based intrauterine devices
    • Pregnancy in the postpartum
    on Naegele’s rule period (lactational amenorrhoea)

    If the interval of cycles is longer than 28/7, the extra days are to be added
    and if the interval is shorter, the days are to be subtracted to get the EDD
    7
    Confirm by time of
    onset of pregnancy
    symptoms

    Using dates, early


    • Typically, these begin pregnancy symptoms
    around 5+ weeks of should occur about
    gestation 5 - 6 weeks
    from the 1st day of
    • commonly include the LMP
    nausea, headache,
    loss of appetite etc..

    8
    Add 22/52 in
    primigravidae & 24/52
    in multiparae to the date
    of quickening = EDD

    Time of Can be used as an


    Quickening estimation in the
    absence of other more
    reliable methods

    Inaccurate

    9
    PHYSICAL
    EXAMINATIO
    N

    10
    •P/E b itself is
    P/E augments y
    inaccurate
    history • What it can dois
    confirm to the
    historical
    findings
    • P/E is more helpful
    in later pregnancy

    Height of the Uterus


    Refers to the
    Symphysio- Fundal-Height
    (SFH) Corresponds with the
    Period of Gestation (POG)
    Is widely influenced by the state
    of the pregnancy - may be
    smaller or larger than dates
    11
    If the cervix becomes
    Very late shorter and dilated, labour
    is not far off
    pregnancy This suggests a term
    pregnancy but cannot date
    it conclusively
    • If the gestation is uncertain
    late on..
    Cervical assessment
    • cervical assessment may
    indicate maturity • cervical length, position and
    consistency are most useful
    • as a component of the • a short, anterior and soft cervix
    Bishop score, cervical is usually present after 3 8 weeks
    assessment may help maturity
    denote the likelihood of • although cervical shortening &
    successful vaginal delivery position may not change,
    changes in consistency almost
    always do
    12
    Ultrasound scanning

    13
    Not all scans during pregnancy
    Ultrasonography serve the same purpose

    early pregnancy
    scans are the
    most accurate
    for dating

    midtrimester
    scans are used
    for anomaly
    assessment
    Crown-Rump Length (CRL)
    3rd trimester
    scans may assess
    liquor volume &
    fetal weight
    accurately but
    are useless for
    dating
    14
    It is crucial that the mother
    Early Pregnancy is questioned if a scan
    was done early in
    Scan pregnancy
    If so, she should be asked
    if the findings
    • Termed as a scan done corresponded to the LMP
    dates
    b efore14weeks
    gestation In clinical practice, if the
    discrepancy between menstrual
    • The CRL is the & u/s dates is < 7 days, the
    desired measurement LMP dates should be employed
    (as long as the periods are
    • Accurate up to a day! regular)

    • All mothers should have If the discrepancy is more then


    this the EDD should be based on
    ultrasonographic fetal biometry
    15
    The
    EDD

    16
    Estimation of the EDD

    Amongst all the methods for EDD


    assessment, a high quality ultrasound scan
    early in pregnancy is the best estimate

    EDD has traditionally been based on


    LMP
    but this has been found to be
    unreliable as about half of women
    cannot accurately recall the 1st day of their LMP,
    have irregular menses
    and the timing of ovulation varies
    17
    Summary

    18
    Estimation of GA & EDD is usually dependant on
    history (LMP)

    GA & EDD should be confirmed by other


    historical features, physical exam and
    ultrasound scan early

    A high quality ultrasound measurement of the


    embryo or fetes within the 1st 14 weeks is the
    most accurate method of confirming GA &
    establishing EDD

    The GA & EDD should be documented clearly in


    the records as soon as confirmation is made via
    an accurate calculation of the LMP, u/s or both
    19
    REFERENCES
    • Konar H, D.C. Dutta’s Textbook of Obstetrics, 7 t h
    Edition, New Central Book Agency, 2 0 1 0

    • Mongelli M and Gardosi J, Update 1 9 April 2010,


    Evaluation of Gestation, Emedicine.medscape.com,
    Extracted from:
    http://emedicine.medscape.com/
    article/259269-overview

    • New guidelines standardize pregnancy due


    date estimates. Medscape. Sep 2 5 2 0 1 4

    20
    Accurate!

    Thank You Very Much


    21

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