Accuracy of Ultrasound to Determine Gestational Age in Third Trimester
Author(s)
Hebah A. Falatah,
Ibrahim A. Awad,
Hanan Y. Abbas,
Maway A. Khafaji,
Khalid G. H. Alsafi,
Saddig D. Jastaniah*
Affiliation(s)
Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA. Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University,Jeddah, KSA. Department of Radiology, School of Medicine, King Abdulaziz University, Jeddah, KSA.
Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA. Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University,Jeddah, KSA. Department of Radiology, School of Medicine, King Abdulaziz University, Jeddah, KSA.
ABSTRACT
Rapid and accurate determination of gestational age (GA) may be vital to the appropriate care of the critically ill pregnant patient and improve obstetric care through allowing the optimal timing of necessary interventions and the avoidance of unnecessary ones. Ultrasound scans are considered to be the most cost-effective, accurate and safe methods for measurement of various fetal parts in pregnant women. The aim of this research is to explore the accuracy of ultrasound in determining gestational age of fetus in third trimesters. Data collected for all pregnant women referred to the Maternity & Children’s Hospital in Jeddah. Only women with single live fetus were included in this study. Women who participated in the study were selected on following criteria: Regular menstrual cycles, known date of last menstrual period and previous live normal neonates in multipara. All scans were performed by a single ultrasonologist on one ultrasound machine. From collected data, it was found that out of 53 (100%) patients, 44 (84.62%) pregnant woman have different gestational age from US and last menstrual period (LMP). From this study we can conclude that the main method to follow fetus growth in third trimester not biparietal diameter (BPD) measurement only. The BPD in third trimester is not reliable and be useless when the patient pass 30 weeks and the BPD has to be side with other measurements when we take it in later trimesters to emphasize the normal growth of fetus and avoid wrong measurement of ultrasound.
Rapid and accurate determination of gestational age (GA) may be vital to the appropriate care of the critically ill pregnant patient and improve obstetric care through allowing the optimal timing of necessary interventions and the avoidance of unnecessary ones. Ultrasound scans are considered to be the most cost-effective, accurate and safe methods for measurement of various fetal parts in pregnant women. The aim of this research is to explore the accuracy of ultrasound in determining gestational age of fetus in third trimesters. Data collected for all pregnant women referred to the Maternity & Children’s Hospital in Jeddah. Only women with single live fetus were included in this study. Women who participated in the study were selected on following criteria: Regular menstrual cycles, known date of last menstrual period and previous live normal neonates in multipara. All scans were performed by a single ultrasonologist on one ultrasound machine. From collected data, it was found that out of 53 (100%) patients, 44 (84.62%) pregnant woman have different gestational age from US and last menstrual period (LMP). From this study we can conclude that the main method to follow fetus growth in third trimester not biparietal diameter (BPD) measurement only. The BPD in third trimester is not reliable and be useless when the patient pass 30 weeks and the BPD has to be side with other measurements when we take it in later trimesters to emphasize the normal growth of fetus and avoid wrong measurement of ultrasound.
Cite this paper
Falatah, H. , Awad, I. , Abbas, H. , Khafaji, M. , Alsafi, K. and Jastaniah, S. (2014) Accuracy of Ultrasound to Determine Gestational Age in Third Trimester. Open Journal of Medical Imaging, 4, 126-132. doi: 10.4236/ojmi.2014.43018.
Falatah, H. , Awad, I. , Abbas, H. , Khafaji, M. , Alsafi, K. and Jastaniah, S. (2014) Accuracy of Ultrasound to Determine Gestational Age in Third Trimester. Open Journal of Medical Imaging, 4, 126-132. doi: 10.4236/ojmi.2014.43018.
References
[1] Kalish, R.B. and Chervenak, F.A. (2005) Sonographic Determination of Gestational Age. The Ultrasound Review of Obstetrics & Gynecology, 5, 254-258.
http://dx.doi.org/10.1080/14722240500390166 [2] Brooke, O.G., Butters, F., Wood, C., Bailey, P. and Tukmachi, F. (1981) Size at Birth from 37- 41 Weeks Gestation: Ethnic Standards for British Infants of Both Sexes. Journal of Human Nutrition, 35, 415-30. [3] Gabbe, S., Niebyl, J.R. and Simpson J.L. (1990) Obstetrics: Normal and Problem Goldstein, S.R. Early Detection of Pathologic Pregnancy by Transvaginal Ultrasonography. Journal of Clinical Ultrasound, 18, 262-273.
http://dx.doi.org/10.1002/jcu.1870180409 [4] Bottomley, C. and Bourne, T. (2009) Dating and Growth in the First Trimester. Best Practice & Research Clinical Obstetrics & Gynaecology, 23, 439-452.
http://dx.doi.org/10.1016/j.bpobgyn.2009.01.011 [5] Salomon, L.J., Alfirevic, Z., Bilardo, C.M., Chalouhi, G.E., Ghi, T., Kagan, K.O., et al. (2013) ISUOG Practice Guidelines: Performance of First-Trimester Fetal Ultrasound Scan. Ultrasound in Obstetrics & Gynecology, 41, 102-113.
http://dx.doi.org/10.1002/uog.12342 [6] Caughey, A.B., Nicholson, J.M. and Washington, A.E. (2008) First- vs Second-Trimester Ultrasound: The Effect on Pregnancy Dating and Perinatal Outcomes. American Journal of Obstetrics & Gynecology, 198, 703-705.
http://dx.doi.org/10.1016/j.ajog.2008.03.034 [7] Hughes, R., Aitken, E., Anderson, J., Barry, C., Benton, M. and Elliot, J. (2008) National Institute for Health and Clinical Excellence. Antenatal Care. Routine Care for the Healthy Pregnant Woman. NICE Clinical Guideline 62. RCOG Press, London. [8] Dietz, P.M., et al. (2007) A Comparison of LMP-Based and Ultrasound-Based Estimates of Gestational Age Using Linked California Livebirth and Prenatal Screening Records. Paediatric and Perinatal Epidemiology, 21, 62-71.
http://dx.doi.org/10.1111/j.1365-3016.2007.00862.x [9] Waldenstrom, U., Axelsson, O. and Nilsson, S. (1990) A Comparison of the Ability of a Sonographically Measured Biparietal Diameter and the Last Menstrual Period to Predict the Spontaneous Onset of Labor. Obstetrics & Gynecology, 76, 33. [10] Nyberg, D.A. (2003) Diagnostic Imaging of Fetal Anomalies. 2nd Edition, Lippincott Williams Wilkins, Philadelphia, 32-34. [11] Chervenak, F.A., Skupski, D.W., Romero, R., Myers, M.K., Smith-Levitin, M., Rosenwaks, Z., et al. (1998) How Accurate Is Fetal Biometry in the Assessment of Fetal Age? American Journal of Obstetrics & Gynecology, 178, 678-687.
http://dx.doi.org/10.1016/S0002-9378(98)70477-6 [12] Wisser, J., Dirschedl, P. and Krone, S. (1994) Estimation of Gestational Age by Transvaginal Sonographic Measurement of Greatest Embryonic Length in Dated Human Embryos. Ultrasound in Obstetrics & Gynecology, 4, 457-462.
http://dx.doi.org/10.1046/j.1469-0705.1994.04060457.x [13] Hadlock, F.P., Harrist, R.B. and Martinez-Poyer, J. (1991) How Accurate Is Second Trimester Fetal Dating? Journal of Ultrasound in Medicine, 10, 557-561. [14] Benson, C. and Doubilet, P.M. (1991) Sonographic Prediction of Gestational Age: Accuracy of Second- and Third-Trimester Fetal Measurements. American Journal of Roentgenology, 157, 1275-1277.
http://dx.doi.org/10.2214/ajr.157.6.1950881 [15] Shalev, E., Feldman, E., Weiner, E. and Zuckerman, H. (1985) Assessment of Gestational Age by Ultrasonic Measurement of the Femur Length. Acta Obstetricia et Gynecologica Scandinavica, 64, 71-74.
http://dx.doi.org/10.3109/00016348509154691 [16] Honarvar, M. and Allahyari, M. (1999) Assessment of Gestational Age Based on Ultrasonic Femur Length in Fetus. Acta Medica Iranica, 37, 134-138.
[1] Kalish, R.B. and Chervenak, F.A. (2005) Sonographic Determination of Gestational Age. The Ultrasound Review of Obstetrics & Gynecology, 5, 254-258.
http://dx.doi.org/10.1080/14722240500390166 [2] Brooke, O.G., Butters, F., Wood, C., Bailey, P. and Tukmachi, F. (1981) Size at Birth from 37- 41 Weeks Gestation: Ethnic Standards for British Infants of Both Sexes. Journal of Human Nutrition, 35, 415-30. [3] Gabbe, S., Niebyl, J.R. and Simpson J.L. (1990) Obstetrics: Normal and Problem Goldstein, S.R. Early Detection of Pathologic Pregnancy by Transvaginal Ultrasonography. Journal of Clinical Ultrasound, 18, 262-273.
http://dx.doi.org/10.1002/jcu.1870180409 [4] Bottomley, C. and Bourne, T. (2009) Dating and Growth in the First Trimester. Best Practice & Research Clinical Obstetrics & Gynaecology, 23, 439-452.
http://dx.doi.org/10.1016/j.bpobgyn.2009.01.011 [5] Salomon, L.J., Alfirevic, Z., Bilardo, C.M., Chalouhi, G.E., Ghi, T., Kagan, K.O., et al. (2013) ISUOG Practice Guidelines: Performance of First-Trimester Fetal Ultrasound Scan. Ultrasound in Obstetrics & Gynecology, 41, 102-113.
http://dx.doi.org/10.1002/uog.12342 [6] Caughey, A.B., Nicholson, J.M. and Washington, A.E. (2008) First- vs Second-Trimester Ultrasound: The Effect on Pregnancy Dating and Perinatal Outcomes. American Journal of Obstetrics & Gynecology, 198, 703-705.
http://dx.doi.org/10.1016/j.ajog.2008.03.034 [7] Hughes, R., Aitken, E., Anderson, J., Barry, C., Benton, M. and Elliot, J. (2008) National Institute for Health and Clinical Excellence. Antenatal Care. Routine Care for the Healthy Pregnant Woman. NICE Clinical Guideline 62. RCOG Press, London. [8] Dietz, P.M., et al. (2007) A Comparison of LMP-Based and Ultrasound-Based Estimates of Gestational Age Using Linked California Livebirth and Prenatal Screening Records. Paediatric and Perinatal Epidemiology, 21, 62-71.
http://dx.doi.org/10.1111/j.1365-3016.2007.00862.x [9] Waldenstrom, U., Axelsson, O. and Nilsson, S. (1990) A Comparison of the Ability of a Sonographically Measured Biparietal Diameter and the Last Menstrual Period to Predict the Spontaneous Onset of Labor. Obstetrics & Gynecology, 76, 33. [10] Nyberg, D.A. (2003) Diagnostic Imaging of Fetal Anomalies. 2nd Edition, Lippincott Williams Wilkins, Philadelphia, 32-34. [11] Chervenak, F.A., Skupski, D.W., Romero, R., Myers, M.K., Smith-Levitin, M., Rosenwaks, Z., et al. (1998) How Accurate Is Fetal Biometry in the Assessment of Fetal Age? American Journal of Obstetrics & Gynecology, 178, 678-687.
http://dx.doi.org/10.1016/S0002-9378(98)70477-6 [12] Wisser, J., Dirschedl, P. and Krone, S. (1994) Estimation of Gestational Age by Transvaginal Sonographic Measurement of Greatest Embryonic Length in Dated Human Embryos. Ultrasound in Obstetrics & Gynecology, 4, 457-462.
http://dx.doi.org/10.1046/j.1469-0705.1994.04060457.x [13] Hadlock, F.P., Harrist, R.B. and Martinez-Poyer, J. (1991) How Accurate Is Second Trimester Fetal Dating? Journal of Ultrasound in Medicine, 10, 557-561. [14] Benson, C. and Doubilet, P.M. (1991) Sonographic Prediction of Gestational Age: Accuracy of Second- and Third-Trimester Fetal Measurements. American Journal of Roentgenology, 157, 1275-1277.
http://dx.doi.org/10.2214/ajr.157.6.1950881 [15] Shalev, E., Feldman, E., Weiner, E. and Zuckerman, H. (1985) Assessment of Gestational Age by Ultrasonic Measurement of the Femur Length. Acta Obstetricia et Gynecologica Scandinavica, 64, 71-74.
http://dx.doi.org/10.3109/00016348509154691 [16] Honarvar, M. and Allahyari, M. (1999) Assessment of Gestational Age Based on Ultrasonic Femur Length in Fetus. Acta Medica Iranica, 37, 134-138.