Crown-rump length and gestational age - a critical appraisal of a 28 year-old formula

Screening of fetal aneuploidies in early pregnancy is a well-established method in the materno-fetal medicine. The aim of our study was to analyze if the medians recommended by the manufacturers are adequate to perform an accurate screening or if there is a need for own laboratory medians calculation in second trimester biochemical marker screening.Sera were collected between 14 wp and 22 wp from 3374 singleton pregnancies. We analyzed three second trimester biochemical markers (AFP, hCG and free Estriol) concentration in all pregnant women and in a subgroup of pregnant women in which gestational age was determined based on crown-rump length. Our results showed that for all biochemical markers the difference between the manufacturer and the own calculated median was lower than 10% excepting the hCG value in the group of pregnant women in which the gestational age was determined on basis of crown-rump-length. Our results show it is recommended to replace the values of the median for hCG measurement with the own laboratory calculated medians. This does not seem to be necessary in the case of AFP and free Estriol measurement.

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Gestational Age and Ultrasonic Measurement of Gestational Sac, Crown-Rump Length and Biparietal Diameter During First 15 Weeks of Pregnancy

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.3109/00016348209156563 ◽

1982 ◽

Vol 61 (3) ◽

pp. 233-235 ◽

Cited By ~ 9

Author(s):

Anders Selbing

Keyword(s):

Gestational Age ◽

Ultrasonic Measurement ◽

Crown Rump Length ◽

Biparietal Diameter ◽

Gestational Sac

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Association of Crown-Rump Length at 11 to 14 Weeksʼ Gestation and Risk of a Large-for-Gestational-Age Neonate

Obstetrical & Gynecological Survey ◽

10.1097/ogx.0b013e3182021f85 ◽

2011 ◽

Vol 66 (1) ◽

pp. 10-11

Author(s):

Joseph Pardo ◽

Yoav Peled ◽

Yariv Yogev ◽

Nir Melamed ◽

Avi Ben-Haroush

Keyword(s):

Gestational Age ◽

Large For Gestational Age ◽

Crown Rump Length

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Three-dimensional ultrasound first trimester fetal volume measurement and its relation to pregnancy outcome

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0315 ◽

2017 ◽

Vol 45 (9) ◽

Author(s):

Haitham A. Torky ◽

Asem A. Moussa ◽

Ali M. Ahmad ◽

Osama Dief ◽

Manar A. Eldesoouky ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Pregnancy Outcome ◽

Gestational Age ◽

Preterm Labor ◽

Three Dimensional ◽

First Trimester ◽

3D Ultrasound ◽

Secondary Outcome ◽

Crown Rump Length

AbstractAim of work:To determine whether fetal volume (FV) measured by three-dimensional (3D) ultrasound was able to detect fetuses at risk of low birth weight (primary outcome) and/or preterm labor (secondary outcome).Methods:One hundred pregnant women carrying a singleton living pregnancy who were sure of dates, and had a dating scan, with gestational age between 11 weeks and 13 weeks+6 days coming for routine first trimester nuchal translucency (NT) were examined by both two-dimensional (2D) and 3D ultrasound (Vocal System) for crown-rump length (CRL) and FV then followed up regularly every 4 weeks until 28 weeks then biweekly until 36 weeks then weekly until delivery both clinically and by ultrasound biometry.Findings:Eighty-seven cases had a normal outcome, while the remaining 13 cases had either preterm labor (four cases) or low-birth weight (nine cases). FV positively correlated with CRL (P=0.026), gestational age in weeks (P=0.002), neonatal body weight in grams (P=0.018) and neonatal body length at birth (P=0.04). A mean FV of 8.3 mmConclusion:3D assessment of FV in the first trimester provides an accurate method for predicting pregnancy outcome namely low birth weight and neonatal complications, however, it is a better positive predictor than a negative one.

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Ultrasound Assessment of Twin Reversed Arterial Perfusion Sequence for the Prediction of Adverse Pregnancy Outcomes in the First Trimester

10.21203/rs.3.rs-142998/v1 ◽

2021 ◽

Author(s):

Ying Tang ◽

Yan Zeng ◽

Taizhu Yang ◽

Pan Yang ◽

Shan Bao ◽

...

Keyword(s):

Gestational Age ◽

Pregnancy Outcomes ◽

First Trimester ◽

Adverse Pregnancy Outcomes ◽

University Hospital ◽

Intrauterine Death ◽

Crown Rump Length ◽

Arterial Perfusion ◽

Adverse Pregnancy ◽

Twin Reversed Arterial Perfusion

Abstract ObjectivesTo investigate twin reversed arterial perfusion (TRAP) sequence for the prediction of TRAP-related adverse pregnancy outcomes at the gestational age of 11-14 weeks. MethodsPregnant women in the first trimester diagnosed with TRAP were recruited at West China Second University Hospital from January 2015 to June 2018. Systematic screening for the pump twin’s crown-rump length (CRL) and acardiac twin’s upper pole-rump length (URL) was conducted using ultrasonic detection. The (CRL-URL)/CRL and URL/CRL ratios were used to assess the pregnancy outcomes for the pump twin. ResultsTwenty-one pregnant women aged 21–39 years with a gestation of 11-14 weeks were recruited. TRAP was diagnosed on average (± standard deviation [SD]) at pregnancy week 13.1 ± 0.18. The pump twins’ mean (± SD) CRL was 6.65 ± 1.1 cm. The incidence of intrauterine death for the pump twins was 19.0% (n=4), the miscarriage rate was 14.3% (n=3), and the live birth rate was 66.7% (n=14). The (CRL-URL)/CRL ratios between the non-survival (intrauterine death and miscarriage) and survival groups significantly differed (0.33 ± 0.08 vs. 0.58 ± 0.08, p < 0.05). Similarly, the URL/CRL ratios between the non-survival and survival groups significantly differed (0.67 ± 0.08 vs. 0.42 ± 0.08, p < 0.05). ConclusionsThe (CRL-URL)/CRL and URL/CRL ratios were valuable indicators for determining pregnancy outcomes of pump twins with TRAP at an early gestational age.

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Sonographic Correlation Between Distal Femoral Epiphysis Ossification Centre And Gestational Age From 28 Weeks To 40 Weeks In Population Of Faisalabad City

Asian Journal of Allied Health Sciences (AJAHS) ◽

10.52229/ajahs.v4i4.387 ◽

2020 ◽

pp. 12-19

Author(s):

OJS Admin

Keyword(s):

Gestational Age ◽

Age Estimation ◽

Abdominal Circumference ◽

Perinatal Morbidity ◽

Ossification Centre ◽

Age Assessment ◽

Crown Rump Length ◽

Biparietal Diameter ◽

Distal Femoral Epiphysis ◽

Ossification Centers

Gestational age assessment is one of the most important tool used for estimation of perinatal morbidity and mortality. Age estimation of fetus can be recorded with the help of various parameters such as biparietal diameter, abdominal circumference, head circumference, length of the kidneys, crown rump length, length of the long bones and ossification centers.

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Morphological study of cleft palate development in 5-fluorouracil-treated hamster fetuses

Development ◽

10.1242/dev.57.1.119 ◽

1980 ◽

Vol 57 (1) ◽

pp. 119-128

Author(s):

Ravindra M. Shah ◽

David T. W. Wong

Keyword(s):

Cleft Palate ◽

Gestational Age ◽

Horizontal Plane ◽

Morphological Study ◽

Fetal Weight ◽

Rating System ◽

Crown Rump Length ◽

Palate Development ◽

Palatal Development

Morphogenesis of palate was studied in normal and 5-fluorouracil-treated hamster fetuses. The results showed that normal palatal development was completed between days 12 and 13 of gestation. In 5-fluorouracil-assaulted palate the reorientation of shelves from a vertical to horizontal plane was delayed. Crown-rump length, gestational age and fetal weight were reliable predictors of the stages of normal palatal development, whereas the morphological rating system was not. Following 5-fiuorouracil treatment, however, crown-rump length, weight and morphological rating were poor indicators of the stage of palatal development.

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Predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-020-05672-6 ◽

2020 ◽

Vol 302 (5) ◽

pp. 1279-1296

Author(s):

Anna Fernlund ◽

Ligita Jokubkiene ◽

Povilas Sladkevicius ◽

Lil Valentin

Keyword(s):

Logistic Regression ◽

Early Pregnancy ◽

Gestational Age ◽

Vaginal Bleeding ◽

Treatment Success ◽

Expectant Management ◽

Crown Rump Length ◽

Multivariable Logistic Regression ◽

Vaginal Deliveries ◽

Gestational Sac

Abstract Purpose To identify predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding. Methods This was a planned secondary analysis of data from a published randomized controlled trial comparing expectant management with vaginal single dose of 800 µg misoprostol treatment of women with embryonic or anembryonic miscarriage. Predefined variables—serum-progesterone, serum-β-human chorionic gonadotropin, parity, previous vaginal deliveries, gestational age, clinical symptoms (bleeding and pain), mean diameter and shape of the gestational sac, crown-rump-length, type of miscarriage, and presence of blood flow in the intervillous space—were tested as predictors of treatment success (no gestational sac in the uterine cavity and maximum anterior–posterior intracavitary diameter was ≤ 15 mm as measured with transvaginal ultrasound on a sagittal view) in univariable and multivariable logistic regression. Results Variables from 174 women (83 expectant management versus 91 misoprostol) were analyzed for prediction of complete miscarriage at ≤ 17 days. In patients managed expectantly, the rate of complete miscarriage was 62.7% (32/51) in embryonic miscarriages versus 37.5% (12/32) in anembryonic miscarriages (P = 0.02). In multivariable logistic regression, the likelihood of success increased with increasing gestational age, increasing crown-rump-length and decreasing gestational sac diameter. Misoprostol treatment was successful in 80.0% (73/91). No variable predicted success of misoprostol treatment. Conclusions Complete miscarriage after expectant management is significantly more likely in embryonic miscarriage than in anembryonic miscarriage. Gestational age, crown-rump-length, and gestational sac diameter are independent predictors of success of expectant management. Predictors of treatment success may help counselling women with early miscarriage.

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