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Ultrasonic Fetal Measurement Standards If we assume a fetus is growing normally, biometric measurements are determined by gestational age, and we can estimate the gestational age and thus the due date. Conditions which alter fetal growth will make the estimates less reliable. Although many embryonic and fetal structures can be measured, only a few measurements are easy and repeatable enough for widespread use. The most common are: The first element to be measurable is the gestation sac of the early pregnancy. The gestational sac is measured in three dimensions, and the average, the Mean Sac Diameter MSD used for estimating gestational age. The length of the embryo on the longest axis excluding the yolk sac constitutes the crown-rump length. The transverse width of the head at it’s widest.

(PDF) Fetal Size and Dating: Charts Recommended for Clinical Obstetric Practice

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Similarly, if a provider believes that extra ultrasounds are necessary and that there is no way to tell a baby’s size or position ‘through all that fat,’ it probably reflects a strong fat-phobic bias on the part of the provider, and is a good sign that a woman should switch providers if at all possible.

Normally the earliest technically satisfactory measurement will be the most accurate for dating purposes. Once the gestational age has been assigned, later measurements should be used to assess fetal size and should not normally be used to reassign gestational age. For dating charts the known variable [crown-rump length CRL or head circumference HC ] is plotted along the horizontal X axis, and the unknown variable gestational age GA on the vertical Y axis. Size charts plot the GA on the X axis and the size variable on the Y axis.

The plotting of measurements on a dating chart can cause confusion to the inexperienced operator. Since a measurement acquired to date a pregnancy is made only once, it is recommended that look-up tables are used for dating purposes in preference to charts. In view of this, only dating tables are presented here. Fetal size can be assessed using either look-up tables or fetal size charts.

The latter are more appropriate. For serial measurements, charts give a visual representation of the fetal size parameters on consecutive occasions. The position of measurements within the normal range can also be assessed. Therefore for fetuses with a dolicocephalic head shape, the head circumference will be within expected limits, but the BPD recorded will be smaller than the normal value for a given GA.

If the BPD measurement is used to date such pregnancies, they will incorrectly be assigned a gestational age which is less than that expected from the last menstrual period LMP or the head circumference measurement. This effect of using the BPD for dating pregnancies has been reported by two groups Hadlock et al.

Free Fetal Size and Dating Template

HCG Levels for normal Pregnancy. The quantitative maternal serum beta HCG peaks at approximately 10 weeks and then reduces. It will be difficult to see if the mother has a retroverted uterus or fibroids. The GS is an echogenic ring surrounding an anechoic centre.

It is effected by skeletal dysplasias, but since these are rare, it is a reliable measurement which confirms measurements of the head.

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Fetal size and dating: Charts recommended for clinical obstetric practice

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Accuracy of the EFW is reported to be best when examinations are performed within 7 days before delivery [38]. ACOG advises “An accurate diagnosis of macrosomia can be made only by weighing the newborn after delivery. J Matern Fetal Neonatal Med. Epub Sep Robert Peter J, et. Cochrane Database Syst Rev. American College of Obstetricians and Gynecologists. Am J Obstet Gynecol. A classification system for selective intrauterine growth restriction in monochorionic pregnancies according to umbilical artery Doppler flow in the smaller twin.

An evaluationof two equations for predicting fetal weight by ultrasound. Am J Obstet Gynecol Radiol Clin North Am.

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The position of measurements within the normal range can also be assessed.

References “The technology of prenatal diagnosis is usually presented to us as a solution, but it brings with it problems of its own If you’ve already read it, you may want to skip ahead. All pregnant women in our technology-happy modern society face confusing choices about prenatal testing, its advantages and disadvantages, and its appropriateness for them.

Large pregnant women face even more confusion, since prenatal testing can be slightly harder in this population, and the results can be more confusing. However, since they may be at a somewhat increased risk for problems like neural tube defects, they also face greater pressure than others to have these prenatal tests, even though the tests are often difficult to interpret. It is further designed to address the special concerns that large women might have in taking these tests their fears, any special equipment or techniques that might be helpful, the controversies over interpretation of results, whether large women have a higher rate of so-called ‘false-positives’ on certain tests and why, etc.

It’s important to remember that discussing prenatal tests can be simple or incredibly complicated, depending on the degree of detail that is needed and the point under discussion. This FAQ is NOT intended to be a full explanation of all the intricacies of taking and interpreting various prenatal tests, but rather a discussion of them as they pertain to large women. A brief description of the test, its purpose, and the procedures used are given for each test, but the majority of the information is about the specifics of large women and the test.

If you need more detail about statistics, interpretation of results, rates of ‘false-positives’, etc. It is also important to realize that most women take these tests without fully considering all of the implications of the test. Most women think of these as a simple test, a cursory part of prenatal care. They don’t consider that intimately wrapped up in the question of prenatal testing is the moral dilemma of abortion and the thorny issue of eugenics.

To ultrasound or not to ultrasound? That is the question. For most pregnant mamas, ultrasounds are just a given. As a natural mama, we want to avoid as many interventions as possible during pregnancy and birth. Some studies also found that when women had an ultrasound for dating they were less likely to be induced for post-term pregnancy.

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