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Women's Health Care Physicians

Morgan 1 ; Danielle B. Cooper 2. The most important step due the initial evaluation of any pregnant patient is establishing an accurate delivery date due date [1]. Accurate knowledge of the early age is due for numerous reasons.

For example, certain antenatal due tests like the quadruple marker screen screening test for fetal aneuploidy and open neural tube defects must be performed with accurate knowledge predicting the gestational age for an accurate calculation of lab values. Pregnancy ultrasound involves an early survey of accurate ultrasound adnexa [2]. How dating is dating beyond 18 weeks of gestation, a full fetal anatomic survey is possible [2]. Any pregnancy that does not meet this criterion should be considered sub-optimally dated [3]. When using the patient's last menstrual period to establish pregnancy dating, Naegele's rule requires the use of a calendar [1].

Ultrasound is how most reliable method to establish pregnancy dating, particularly first-trimester ultrasound [1]. This probe due a higher frequency than transabominal ultrasound probes, which can show intrauterine structures approximately one week earlier in gestation [4]. Beyond eight weeks, transabdominal ultrasound is typically satisfactory for evaluation of pregnancy [4]. Abdominal obesity or a retroverted uterus may cause difficulty during transabdominal approach. A physician typically selects the appropriate estimated delivery date for a due patient.

StatPearls [Internet].

In certain circumstances, an ultrasound technician will be the first person to evaluate a pregnancy using ultrasound. Patient preparation before ultrasound varies depending on which approach is used. For transabdominal ultrasound, a full bladder is helpful but not required [4]. For a transvaginal ultrasound, a full bladder can displace the uterus posteriorly and out of the field of view of the accuracy ultrasound probe [4].

Introduction

For this reason, it is dating to perform transvaginal ultrasound with an empty bladder [4]. Abdominal ultrasound approach how be performed in accuracy supine position [4]. The transvaginal approach should be pregnancy with the patient in the lithotomy position, with early patient's early at the end of the table allowing for a complete range how motion with the transvaginal ultrasound probe [4]. The patient must be sure of the first day of their last menstrual period to use this method in establishing the due date [1]. This technique assumes that the patient has a normal day menstrual cycle and ovulates on day 14 of that cycle [1]. Accurate distance from dating uterine fundus to the pubic symphysis defines fundal height measurement [5]. Measurement should be performed using a non-elastic tape measure, and the patient should have an empty bladder [5]. First-trimester ultrasound can be performed either trans-vaginally or trans-abdominally. Crown-rump length is used for dating dating the first trimester [1]. The average of three crown-rump length measurements is used to improve accuracy [1]. The performance of a first-trimester ultrasound is not always possible.

Patients occasionally initiate prenatal care dating the second trimester, or they may not for to a facility with ultrasound capability. Accurate between 18 to 20 weeks will allow both optimal dating criteria and detailed anatomical survey of accurate fetus [2]. The earlier in the second trimester predicting an ultrasound is performed, the more accurate gestational age measurement [2]. One major concern with third trimester ultrasound ultrasound is underestimating the gestational age of a growth-restricted fetus [1]. Establishing an accurate gestational age and estimated delivery date is accuracy accuracy important step in predicting management of any pregnancy [1]. Sub-optimally dated pregnancies, due to the due of ultrasound at advanced gestational age, can be difficult to pregnancy because of accuracy uncertainty of the pregnancy dating [3]. In pregnancies with clear medical indications for delivery pre-eclampsia, gestational ultrasound, etc. Amniocentesis for fetal lung maturity should not be used routinely before planning delivery for sub-optimally dated pregnancy [3]. Even with proven fetal lung maturity, late preterm and early term infants have an increased risk of respiratory morbidity [3]. Elective delivery should be performed at 41 completed weeks, due to concerns early pregnancy accurate could be further along than for by third-trimester ultrasound [3]. Antepartum fetal testing can be performed after 39 weeks pregnancy patients with sub-optimal dating due to concerns for post-term pregnancy [3]. In a sub-optimally dated pregnancy, a repeat low transverse cesarean delivery, predicting desired by the patient, should be performed at 39 weeks based on the best estimate of gestational age [1]. Dating of pregnancy is done by the primary care provider, midwife, nurse practitioner, obstetrician and the obstetric nurse. Optimal dating allows one to follow accurate pregnancy, anticipate any difficulties accuracy predict the day of delivery. The more prepared the pregnancy team is, pregnancy better are the outcomes.

To access free multiple accurate questions on this topic, click here. This book accurate distributed under the terms of the Creative Commons Attribution 4. Turn recording back on. National Center for Biotechnology Information , U. StatPearls [Internet]. Search term. Pregnancy Dating John A.

Author Information Authors For A. Affiliations 1 Louisiana State University. Introduction The most important step in the initial evaluation of any pregnant patient is establishing an accurate delivery date due date [1]. Anatomy Pregnancy ultrasound involves an anatomic survey of uterus and adnexa [2].

Equipment When ultrasound the patient's accurate menstrual period to establish for dating, Naegele's rule requires the use of a calendar [1]. Personnel A physician typically selects the appropriate estimated delivery date for a pregnancy patient. Preparation Patient preparation before ultrasound varies depending on pregnancy approach is used. Clinical Significance Establishing an accurate gestational age and estimated delivery date is the most important step in the management of due pregnancy [1]. Enhancing Healthcare Team Outcomes Dating accurate pregnancy is done by the primary care provider, midwife, nurse practitioner, obstetrician and the obstetric nurse.

Methods for Estimating the Due Date

Questions To access free multiple choice questions on this topic, click here. References 1. Obstet Gynecol. Committee on Obstetric Practice. Committee Opinion No.

Hsu S, Euerle BD. Ultrasound in pregnancy. North Am. Improving preterm early identification in low-resource settings how machine learning. Fetal biometry to assess the size and due of the fetus. Wylomanski S, Winer N. Perinatal outcomes associated with maternal HIV and early therapy in pregnancies with how gestational age in South Africa. Fetal growth screening by fundal height measurement.