BACKGROUND: Pregnancy dating in the South African public healthcare setting is mainly based on clinical assessment. However, the accuracy of this approach is unknown. AIM: To compare the accuracy of different pregnancy dating methods. METHODS: We performed a prospective comparison of 2 ultrasound policies involving consecutive low-risk women in a midwife clinic in the Metro East region, Cape Town, Western Cape. Information on the last menstrual period (LMP), the 1st symphysis-to-fundal height measurement (FH) and average gestation by ultrasonographic (US) fetal biometry was recorded. Five dating methods: LMP, FH, US and their combinations, were assessed against the actual day of delivery (ADD). The main outcome measures were: (i) the days between the ADD and estimated date of delivery in pregnancies where spontaneous labour occurred and the baby had a normal birth weight; (ii) the incidence of gestational age-related outcomes; and (iii) the influence of clinical variables on dating discrepancies. RESULTS: A total of 1 342 pregnancies were analysed. The accuracy of dating was similar for certain and uncertain LMP. FH was less accurate with increasing obesity. US-based dating was most accurate (for 85% of predictions within 14 days) and similarly accurate at 20 - 24 weeks and at >24 weeks. US reduced the number of assumed pre-and post-term deliveries and, in addition, was better at detecting small-for-gestational age infants (p<0.001). CONCLUSION: Pregnancy dating by US, including those in more advanced pregnancies than currently permitted, is recommended since all non-ultrasound-based estimations of gestational age were considerably less accurate.
BACKGROUND: Pregnancy dating in the South African public healthcare setting is mainly based on clinical assessment. However, the accuracy of this approach is unknown. AIM: To compare the accuracy of different pregnancy dating methods. METHODS: We performed a prospective comparison of 2 ultrasound policies involving consecutive low-risk women in a midwife clinic in the Metro East region, Cape Town, Western Cape. Information on the last menstrual period (LMP), the 1st symphysis-to-fundal height measurement (FH) and average gestation by ultrasonographic (US) fetal biometry was recorded. Five dating methods: LMP, FH, US and their combinations, were assessed against the actual day of delivery (ADD). The main outcome measures were: (i) the days between the ADD and estimated date of delivery in pregnancies where spontaneous labour occurred and the baby had a normal birth weight; (ii) the incidence of gestational age-related outcomes; and (iii) the influence of clinical variables on dating discrepancies. RESULTS: A total of 1 342 pregnancies were analysed. The accuracy of dating was similar for certain and uncertain LMP. FH was less accurate with increasing obesity. US-based dating was most accurate (for 85% of predictions within 14 days) and similarly accurate at 20 - 24 weeks and at >24 weeks. US reduced the number of assumed pre-and post-term deliveries and, in addition, was better at detecting small-for-gestational age infants (p<0.001). CONCLUSION: Pregnancy dating by US, including those in more advanced pregnancies than currently permitted, is recommended since all non-ultrasound-based estimations of gestational age were considerably less accurate.
Authors: Hein Odendaal; Eduard Kieser; Daan Nel; Lucy Brink; Carlie du Plessis; Coen Groenewald; Maristella Lucchini; William P Fifer; Michael M Myers Journal: Int J Gynaecol Obstet Date: 2019-08 Impact factor: 3.561
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Authors: Fernando Althabe; Mabel Berrueta; Jennifer Hemingway-Foday; Agustina Mazzoni; Carolina Astoul Bonorino; Andrea Gowdak; Luz Gibbons; M B Bellad; M C Metgud; Shivaprasad Goudar; Bhalchandra S Kodkany; Richard J Derman; Sarah Saleem; Samina Iqbal; Syed Hasan Ala; Robert L Goldenberg; Elwyn Chomba; Albert Manasyan; Melody Chiwila; Edna Imenda; Florence Mbewe; Antoinette Tshefu; Victor Lokomba; Carl L Bose; Janet Moore; Sreelatha Meleth; Elizabeth M McClure; Marion Koso-Thomas; Pierre Buekens; José M Belizán Journal: PLoS One Date: 2015-03-30 Impact factor: 3.240
Authors: Nastassja Koen; Meaghan J Jones; Raymond T Nhapi; Marilyn T Lake; Kirsten A Donald; Whitney Barnett; Nadia Hoffman; Julia L MacIsaac; Alexander M Morin; David T S Lin; Michael S Kobor; Karestan C Koenen; Heather J Zar; Dan J Stein Journal: Transl Psychiatry Date: 2021-07-02 Impact factor: 6.222