These guidelines reflect emerging clinical and scientific advances as of the date issued and are pregnancy, to date pregnancy when last normal menstrual.
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- Routine ultrasound
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- Guidelines - Prenatal Screening Ontario
J Obstet Gynaecol Can ;30 The use of folic acid in combination with a multivitamin supplement for the prevention of neural tube defects and other congenital anomalies. J Obstet Gynaecol Can ;29 Things to keep in mind: Informed choice — before ordering the test, discuss benefits, risks and limitations. Autonomy — the patient should choose whether to have prenatal screening. What prenatal screening options are available in your area?
What option is most suitable for your patient? Which test will provide the optimal care for your patient? A screening test is not diagnostic. The following recommendations are from: All pregnant persons in Canada, regardless of age, should be offered, through an informed counselling process, the option of a prenatal screening test for the most common fetal aneuploidies II-A.
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- Methods for Estimating the Due Date.
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What is my health care provider looking for on the ultrasound pictures? Your ultrasound s gives important information on many aspects of your pregnancy. Other biometric variables, such as additional long bones and the transverse cerebellar diameter, also can play a role.
- For Health Care Providers.
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. 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.
The best available data support adjusting the EDD of a pregnancy if the first ultrasonography in the pregnancy is performed in the third trimester and suggests a discrepancy in gestational dating of more than 21 days. 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.
For the purposes of research and surveillance, the best obstetric estimate, rather than estimates based on the LMP alone, should be used as the measure for gestational age. The American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal—Fetal Medicine recognize the advantages of a single dating paradigm being used within and between institutions that provide obstetric care.
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. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
Guidelines - Prenatal Screening Ontario
Methods for estimating the due date. American College of Obstetricians and Gynecologists. Women's Health Care Physicians. Recommendations The American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal—Fetal Medicine make the following recommendations regarding the method for estimating gestational age and due date: As soon as data from the last menstrual period 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.
Introduction An accurately assigned EDD early in prenatal care is among the most important results of evaluation and history taking. Clinical Considerations in the Second Trimester Using a single ultrasound examination in the second trimester to assist in determining the gestational age enables simultaneous fetal anatomic evaluation.
Ultrasonography dating in the second trimester typically is based on regression formulas that incorporate variables such as the biparietal diameter and head circumference measured in transverse section of the head at the level of the thalami and cavum septi pellucidi; the cerebellar hemispheres should not be visible in this scanning plane the femur length measured with full length of the bone perpendicular to the ultrasound beam, excluding the distal femoral epiphysis the abdominal circumference measured in symmetrical, transverse round section at the skin line, with visualization of the vertebrae and in a plane with visualization of the stomach, umbilical vein, and portal sinus 8 Other biometric variables, such as additional long bones and the transverse cerebellar diameter, also can play a role.
Conclusion Accurate dating of pregnancy is important to improve outcomes and is a research and public health imperative.
Fetal Imaging Workshop Invited Participants. A comparison of recalled date of last menstrual period with prospectively recorded dates. J Womens Health Larchmt ; Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination. Am J Obstet Gynecol ; Last menstrual period versus ultrasound for pregnancy dating.
Int J Gynaecol Obstet ; First trimester ultrasound screening is effective in reducing postterm labor induction rates: Ultrasound for fetal assessment in early pregnancy.