Thursday, May 25, 2017

ACOG updates its recommendations for estimating gestational age and due date: May 2017


Accurate gestational dating of pregnancy is very important for optimal maternal and fetal outcome.Throughout pregnancy decisions like ordering and interpreting lab tests, determining fetal growth and performing intervention to prevent preterm births or post-term pregnancies and associated morbidities are based on accurate dating.

Estimated Due Date (EDD)and current gestational dating should be documented on medical records and discussed with the patient as early as possible based on dates of Last Menstrual Period(LMP) and earliest available ultrasound in pregnancy.

A first trimester ultrasound can improve the accuracy of predicted EDD, even if date of LMP is known. Many women have irregular cycles, or falsely recall the date of LMP or have irregular ovulation, which is not considered when calculating the EDD by traditional method.

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:

A first trimester ultrasound of the embryo (up to and including 13 6/7 weeks of gestation) is most accurate for calculating or confirming the gestational age. Measuring the crown–rump length (CRL) is accurate up to ±5–7 days and it should be the mean of three discrete CRL measurements when possible.

If the pregnancy is the result of successful ART procedure, then the EDD is calculated based on age of embryo and day of transfer.

As soon as LMP and results of first trimester ultrasound are known, EDD should be calculated and recorded in medical records. It should also be told to patient and discussed with her.

Second trimester ultrasound for gestational dating (14 0/7 weeks to 27 6/7 weeks of gestation) is more complex and introduces more complexities and variability. It incorporates multiple parameters like the biparietal diameter and head circumference, the femur length and the abdominal circumference. The accuracy decreases as we progress further into second trimester, with a variability of ± 10–14 days at the end of second trimester.

Gestational age assessment by ultrasonography in the third trimester (28 0/7 weeks of gestation and beyond) is the least reliable method, with an accuracy of ± 21–30 days.

Pregnancies without an ultrasound examination that confirms or revises the EDD before 22 0/7 weeks of gestational age should be considered suboptimally dated and managed accordingly.

This document replaces the Committee Opinion Number 611, (October 2014).

The full text of the committee opinion can be accessed here. 

16 comments:

  1. have Questions on Pregnancy Calculator and How many weeks pregnant Am I? this is the general question every pregnant questions her self.
    how many weeks pregnant am i

    ReplyDelete
    Replies
    1. MY HIV HEALING TESTIMONY

      My mouth is short of words, i am so happy because Dr voodoo has healed me
      from HIV ailment which i have been suffering from the past 5years now, i
      have spend a lot when getting drugs from the hospital to keep me healthy, i
      have tried all means in life to always i can become HIV negative one day,
      but there was no answer until i found Dr voodoo the parish of African who
      provide me some healing spell that he uses to help me, now i am glad
      telling everyone that i am now HIV Negative, i am very happy, thank you Dr
      voodoo for helping my life comes back newly without any form of crisis, may
      the good lord that i serve blessed you Dr voodoo and equip you to the
      higher grade for healing my life. i am so amazed. so i will announced to
      everyone in this whole world that is HIV positive to please follow my
      advice and get healed on time, because we all knows that HIV disease is a
      deadly type,contact Dr voodoo for your HIV healing spell today at:
      voodoospelltemple66@gmail.com Contact Dr. VOODOO on: /WhatsApp no:or call
      him +2348140120719 OR email him at: voodoospelltemple66@gmail.com He will
      be always happy to assist you online and ensure you get healed on time,
      contact Dr voodoo today for your healing spell immediately, thank you sir.

      Delete
    2. Hello viewers I am glad to have met with the powerful herbal healer called
      Dr voodoo who use his herbs to cure my HIV disease I suffered from 15years,
      but now I am a happy woman and i am free from this sickness that has been
      problem to my living, after using Dr voodoo herbal medicine within 1week i
      was diagnose negative, I will recommend Dr voodoo to everyone reading this
      article because this herbal healer is capable to heal anything, the
      scientist said has no cure, Email him : voodoospelltemple66@gmail.com or
      add Dr voodoo on whatsApp: +2348140120719


      Hello viewers I am glad to have met with the powerful herbal healer called
      Dr voodoo who use his herbs to cure my HIV disease I suffered from 15years,
      but now I am a happy woman and i am free from this sickness that has been
      problem to my living, after using Dr voodoo herbal medicine within 1week i
      was diagnose negative, I will recommend Dr voodoo to everyone reading this
      article because this herbal healer is capable to heal anything, the
      scientist said has no cure, Email him : voodoospelltemple66@gmail.com or
      add Dr voodoo on whatsApp: +2348140120719

      Delete
  2. Thanks for your post which is truly informative for us and we will surely keep visiting this website.
    diagnostic centres list in secunderabad
    diabetic health checkup at manikonda

    ReplyDelete
    Replies
    1. REAL CURE ON HERPES SIMPLEX VIRUS AND HIV some times we just need to give a try to herbal Medicine to see for our self. I am very happy today that i do not listen to what people say if not i would have been a dead woman by now. I was infected with HERPES SIMPLEX VIRUS in 2017, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution out so that my body can be okay. One day I was in the office thinking where I can go to get solution. so a lady walked to me telling me why am I so sad and i open up all to her telling her my problem, she told me that she can help me out, she introduce me to a doctor who uses herbal medication to cure HERPES SIMPLEX VIRUS, HIV, HPV and many more disease and she gave me his email, so i mail him. Doc. Chukwu madu told me all the things I need to do and send me the herbal medicine through courier delivering service and also give me instructions to take, which I followed properly. Before I knew what is happening after 2 weeks the HERPES SIMPLEX VIRUS that was in my body got vanished and blister dried off . I went to the hospital for a test and it was negative. Dr.Chukwu madu is real and he is the solution to herpes virus. so if you are also heart broken and also need a help, you can also email him via his personal email. dr.chukwumaduherbalhome@gmail.com (call or whatsapp +2347030936239 according to this great DR he can also cure HIV, ALS,CANCER, COLD SORE, HPV AND DIABETES

      Delete
  3. Greatest thanks to Dr Oyagu for his herbal drugs that he prepared for me and when i start using it in just 2weeks i was completely cured and that ended my HERPES SIMPLEX 1&2 DISEASE i am so happy and grateful to Dr Oyagu . after reading about him on a testimony of Jason Cash on a blogger. i knew suddenly Dr Oyagu was the right Doctor to cure my HERPES SIMPLEX 1&2 DISEASE. i discuss with Dr Oyagu and he prepared a herbal medicine for me and when it got sent to me in south korean . i used the herbal medicine and 2weeks and i went to check up again. after 15years of suffering from HERPES SIMPLEX 1&2 at last i am smiling once again. Dr Oyagu also has remedy to others disease like COLD SORES,HIV/AIDS,DIABETES.CANCER,HIGH BLOOD PRESSURE AND MANY MORE. I oblige everyone to contact this powerful herbalist Dr Oyagu and be free from your suffering. contact his WhatsApp line: +2348101755322 or his Email:Oyaguherbalhome@gmail.com

    ReplyDelete
  4. I never thought that there will be a miracle on the internet until i came in contact with Priest Babaka, finally i made it with his help, with his spiritual power which was recommended by a lady in baby center he help before, i never believe it was real until i confirm it now because i have tried so many things to make sure i get pregnant but no luck, immediately i contact him. he did some spiritual prayers and send me a medicine which i took, i got pregnant three weeks after, and i now have a son to show. thank you so much priest and i recommend Priest Babaka for everyone out there that is willing to have a child of her own out there. contact him for help too he is real and powerful, i have confirmed it, contact him on email: babaka.wolf@gmail.com or Facebook at priest.babaka
















    I never thought that there will be a miracle on the internet until i came in contact with Priest Babaka, finally i made it with his help, with his spiritual power which was recommended by a lady in baby center he help before, i never believe it was real until i confirm it now because i have tried so many things to make sure i get pregnant but no luck, immediately i contact him. he did some spiritual prayers and send me a medicine which i took, i got pregnant three weeks after, and i now have a son to show. thank you so much priest and i recommend Priest Babaka for everyone out there that is willing to have a child of her own out there. contact him for help too he is real and powerful, i have confirmed it, contact him on email: babaka.wolf@gmail.com or Facebook at priest.babaka

    ReplyDelete
  5. I'm here to share to the worldwide that Dr Kham is a Powerful Herbal Medicine man. that can cure your disease if you can only contact him and let him help you. I was cured from my Herpes virus. After suffering since 5 months but when i contact him on the internet. he gave me a Natural cure that ended my suffering after using it for two weeks. i went to check myself on the hospital and i was tested negative. I Want to say thank you sir and i use this medium to say to everyone don't waste any time contact this powerful herbal Dr Kham On any Kind of Disease he is Ready to help you. You can reach him through Email: dr.khamcaregiver@gmail.com or Whats App him +2348159922297 check his website: https://drkhamherbalhealingcenter.wordpress.com/ He also have a herbal cure for Following DISEASES,this is 100% Real-COLD SORE -ALS -LOWER RESPIRATORY INFECTION -LOW SPERM COUNT -STAPHYLOCOCCUS AUREUS -STROKE -IMPOTENCE -PILE -HYPERTENSION -LOW SPERM COUNT -ASTHMA -CANCER -BARENESS/INFERTILITY -FIBROID -ASTHMA -SICKLE CELL -BARENESS/INFERTILITY -DIARRHEA and so on.

    ReplyDelete
  6. I was married at 32 and immediately tried to get pregnant. When I was unable to conceive I had blood tests for fertility and was told that I had an FSH (follicle stimulating hormone) of 54 and would not be able to have children. Even though the doctors knew that I had been diagnosed with Hashimoto’s thyroiditis since age 25, no one bothered to check my thyroid levels. my TSH was measured at .001. My Synthroid dosage was lowered. a friend advise me to contact a spiritualist who help with fertility with his medicine, i collected his contact and explain my situation to him he prepared for me a herbal medicine which i took as describe by him. became pregnant very quickly, I had a successful pregnancy. I have my baby august 2017. to get pregnant at age 35 with my 2nd child in september 2019, thank you sir , this is his email contact if you require his help babaka.wolf@gmail.com or Facebook at priest.babaka











    I was married at 32 and immediately tried to get pregnant. When I was unable to conceive I had blood tests for fertility and was told that I had an FSH (follicle stimulating hormone) of 54 and would not be able to have children. Even though the doctors knew that I had been diagnosed with Hashimoto’s thyroiditis since age 25, no one bothered to check my thyroid levels. my TSH was measured at .001. My Synthroid dosage was lowered. a friend advise me to contact a spiritualist who help with fertility with his medicine, i collected his contact and explain my situation to him he prepared for me a herbal medicine which i took as describe by him. became pregnant very quickly, I had a successful pregnancy. I have my baby august 2017. to get pregnant at age 35 with my 2nd child in september 2019, thank you sir , this is his email contact if you require his help babaka.wolf@gmail.com or Facebook at priest.babaka

    ReplyDelete
  7. An hacker helped me to spy on my wife’s WhatsApp,mails and every text message that was sent to her iPhone and every deleted messages of the past six months you can message him through this number (+13852501115) or contact him via email at brillianthackers800@gmail.com

    ReplyDelete
  8. REAL CURE ON HERPES SIMPLEX VIRUS AND HIV some times we just need to give a try to herbal Medicine to see for our self. I am very happy today that i do not listen to what people say if not i would have been a dead woman by now. I was infected with HERPES SIMPLEX VIRUS in 2017, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution out so that my body can be okay. One day I was in the office thinking where I can go to get solution. so a lady walked to me telling me why am I so sad and i open up all to her telling her my problem, she told me that she can help me out, she introduce me to a doctor who uses herbal medication to cure HERPES SIMPLEX VIRUS, HIV, HPV and many more disease and she gave me his email, so i mail him. Doc. Chukwu madu told me all the things I need to do and send me the herbal medicine through courier delivering service and also give me instructions to take, which I followed properly. Before I knew what is happening after 2 weeks the HERPES SIMPLEX VIRUS that was in my body got vanished and blister dried off . I went to the hospital for a test and it was negative. Dr.Chukwu madu is real and he is the solution to herpes virus. so if you are also heart broken and also need a help, you can also email him via his personal email. dr.chukwumaduherbalhome@gmail.com (call or whatsapp +2347030936239 according to this great DR he can also cure HIV, ALS,CANCER, COLD SORE, HPV AND DIABETES

    ReplyDelete
  9. I never thought that there will be a miracle on the internet until i came in contact with Priest Babaka, finally i made it with his help, with his spiritual power which was recommended by a lady in baby center he help before, i never believe it was real until i confirm it now because i have tried so many things to make sure i get pregnant but no luck, immediately i contact him. he did some spiritual prayers and send me a medicine which i took, i got pregnant three weeks after, and i now have a son to show. thank you so much priest and i recommend Priest Babaka for everyone out there that is willing to have a child of her own out there. contact him for help too he is real and powerful, i have confirmed it, contact him on email: babaka.wolf@gmail.com or Facebook at priest.babaka

    ReplyDelete
  10. I Want To Appreciate Dr.zubby for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.zubby Cure Herpes Virus I Decided To Contact Dr.zubby I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr zubby To Help You Too,And Help Me To Thank Dr.zubby For Cure Me, I’m Cured By Dr. Zubby Herbal Medicine,His Contact Email: dr.zubbysolutionhome@gmail.com

    ReplyDelete
  11. I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
    liver already present. I started on antiviral medications which
    reduced the viral load initially. After a couple of years the virus
    became resistant. I started on HEPATITIS B Herbal treatment from
    ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
    treatment totally reversed the virus. I did another blood test after
    the 6 months long treatment and tested negative to the virus. Amazing
    treatment! This treatment is a breakthrough for all HBV carriers.

    ReplyDelete
  12. DO YOU NEED A PERSONAL/BUSINESS/INVESTMENT LOAN? CONTACT US TODAY VIA WhatsApp +19292227023 Email drbenjaminfinance@gmail.com

    HELLO
    Loan Offer Alert For Everyone! Are you financially down and you need an urgent credit/financial assistance? Or are you in need of a loan to start-up/increase your business or buy your dream house. GET YOUR INSTANT LOAN APPROVAL 100% GUARANTEED TODAY NO MATTER YOUR CREDIT SCORE. WhatsApp:+19292227023 Email: drbenjaminfinance@gmail.com

    ReplyDelete