Dating scan gestational age








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A new way to estimate fetal age. Clin Obstet Gynecol Analysis of biparietal diameter as an accurate indicator of gestational age. The accuracy of gestational age estimation by HC measurement is comparable with that of BPD measurement. Measurement of the AC is performed in the same manner as that of the HC, that is, by 1 tracing the outer perimeter of the AC by the trackball on the ultrasonic equipment or by digitizer or 2 the same equation as for HC using transverse and anteroposterior diameters of the fetal abdomen. Gestational age can be more accurately predicted by obtaining paired BPD measurements the first from 20 to 26 weeks' gestation and the second from 31 to 33 weeks' gestation and assigning gestational age by a method developed by Sabbagha and co-workers 79 known as growth-adjusted sonographic age GASA. Table 3 summarizes the results of these three studies evaluating gestational age relative to CRL.

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Twin and singleton growth patterns compared using ultrasound. If menstrual dates are unknown, or the difference between menstrual dates and the mean gestational age predicted by single or multiple parameters is greater than the range of error of these measurements, fetal age should be established using the best ultrasound predictors either single or multiple parameters or GASA method. Measurements of a wide variety of parameters have been devised to establish gestational age. In addition, several technical factors are potential sources of error in the measurement of the femur.

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In general, ultrasound-derived fetal dating tables obtained for singleton pregnancies can be used accurately for twin pregnancies until approximately 30 weeks' gestation. Multiple Fetal Growth Parameters Hadlock and co-workers 80 , 81 combined several measurements in an effort to increase the accuracy of gestational age assessment. Fetal femur length as a predictor of menstrual age. Biologic variation may lead to inaccuracies of FL measurements in a manner similar to that of the other fetal growth parameters. Gestational age, synonymous with menstrual age, is defined in weeks beginning from the first day of the last menstrual period LMP prior to conception. Ultrasonographic identification of fetal lower extremity epiphyseal ossification centers. Averaging of fetal growth parameters should be avoided when certain conditions are suspected, such as fetal macrosomia, intrauterine growth retardation both symmetric and asymmetric , and congenital anomalies skeletal dysplasias, hydrocephalus, and others.

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Description: At 5 to 6 weeks' gestation, distinct landmarks cannot always be identified but heart motion usually can be detected centrally. Transaxial image of the upper fetal abdomen. Fetal biometric data are available for twin gestations 81 , 82 , 83 , 84 , 85 . however, triplet and quadruplet pregnancies have not been adequately studied owing to their infrequent occurrence. The distal femoral epiphysis becomes echogenic in the third trimester and is separated from the distal end of the diaphysis, the osseous portion of the shaft. Time of ovulation in relation to cycle length. Similarly, dates in the large-for-gestational age fetus may be adjusted by GASA at the time of the second BPD measurement, decreasing gestational age assignment by 1 week if the BPD measurement is greater than or equal to the 90th percentile Fig. Accuracy of ultrasound in fetal femur length determination. Use of alpha-fetoprotein in prenatal diagnosis. In contrast, BPD growth in the small-for-gestational age fetus will follow a slow growth pattern and the second BPD measurement will be less than or equal to the 10th percentile for the gestational age assigned by the first BPD. The longitudinal diameter is measured between the small crosses 1 and the anteroposterior diameter is measured between the larger crosses 2.
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