Survival and neonatal morbidity among extremely preterm born infants in relation to gestational age based on the last menstrual period or ultrasonographic examination

Objective. To evaluate the agreement of risk categorization for Down syndrome screening between ultrasound scan-based gestational age (GA) and last menstrual period-based gestational age in both first and second trimesters by maternal serum markers. Methods. Data comprising 4,055 and 4,016 cases of first and second trimester screening were used. The maternal serum markers were analyzed using the ultrasound-based GA and menstrual age. The subjects whose menstrual age and ultrasound-based GA fell in different trimesters were excluded because the risk could not be calculated due to the different serum markers used in each trimester. The agreement of risk categorization for fetal Down syndrome was evaluated. Results. The agreement of Down syndrome screening in the first and the second trimesters were 92.7% and 89%, respectively. The study found a good agreement of risk categorization by Kappa index, which was 0.615 for the overall screening. The menstrual age had a slight decrease in the detection rate and a lower false-positive rate. Conclusion. Menstrual age is acceptable in cases of accurate last menstrual period. However, in places where ultrasonography is not readily available, gestational age estimation by menstrual age along with clinical examination that corresponds to the gestational age can be reliable.

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Association of gestational age with MRI-based biometrics of brain development in fetuses

BMC Medical Imaging ◽

10.1186/s12880-020-00525-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yuequan Shi ◽

Yunjing Xue ◽

Chunxia Chen ◽

Kaiwu Lin ◽

Zuofu Zhou

Keyword(s):

Regression Model ◽

Brain Development ◽

Fetal Growth ◽

Gestational Age ◽

Rapid Growth ◽

Polynomial Regression ◽

Fetal Brain ◽

Growth Patterns ◽

Menstrual Period ◽

Last Menstrual Period

Abstract Background Reported date of last menstrual period and ultrasonography measurements are the most commonly used methods for determining gestational age in antenatal life. However, the mother cannot always determine the last menstrual period with certainty, and ultrasonography measurements are accurate only in the first trimester. We aimed to assess the ability of various biometric measurements on magnetic resonance imaging (MRI) in determining the accurate gestational age of an individual fetus in the second half of gestation. Methods We used MRI to scan a total of 637 fetuses ranging in age from 22 to 40 gestational weeks. We evaluated 9 standard fetal 2D biometric parameters, and regression models were fitted to assess normal fetal brain development. A stepwise linear regression model was constructed to predict gestational age, and measurement accuracy was determined in a held-out, unseen test sample (n = 49). Results A second-order polynomial regression model was found to be the best descriptor of biometric measures including brain bi-parietal diameter, head circumference, and fronto-occipital diameter in relation to normal fetal growth. Normal fetuses showed divergent growth patterns for the cerebrum and cerebellum, where the cerebrum undergoes rapid growth in the second trimester, while the cerebellum undergoes rapid growth in the third trimester. Moreover, a linear model based on biometrics of brain bi-parietal diameter, length of the corpus callosum, vermis area, transverse cerebellar diameter, and cerebellar area accurately predicted gestational age in the second and third trimesters (cross-validation R2 = 0.822, p < 0.001). Conclusions These results support the use of MRI biometry charts to improve MRI evaluation of fetal growth and suggest that MRI biometry measurements offer a potential estimation model of fetal gestational age in the second half of gestation, which is vital to any assessment of pregnancy, fetal development, and neonatal care.

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Comparison of Gestational Age Classifications: Date of Last Menstrual Period vs. Clinical Estimate

Annals of Epidemiology ◽

10.1016/j.annepidem.2007.01.035 ◽

2007 ◽

Vol 17 (6) ◽

pp. 425-430 ◽

Cited By ~ 68

Author(s):

Martha S. Wingate ◽

Greg R. Alexander ◽

Pierre Buekens ◽

Anjel Vahratian

Keyword(s):

Gestational Age ◽

Menstrual Period ◽

Last Menstrual Period

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A Comparison of the Accuracy of the Use of Last Menstrual Period and Symphysio-Fundal Height for Gestational Age Determination among Nigerian Women

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2015/15826 ◽

2015 ◽

Vol 7 (1) ◽

pp. 32-39 ◽

Cited By ~ 1

Author(s):

A. Ogbe ◽

C. Ekwempu ◽

J. Musa ◽

A. Anzaku

Keyword(s):

Gestational Age ◽

Age Determination ◽

Menstrual Period ◽

Last Menstrual Period ◽

Nigerian Women

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Sonographic Reference Values for Fetal Transverse Cerebellar Diameter in the Second and Third Trimesters in a Nigerian Population

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479316687997 ◽

2017 ◽

Vol 33 (3) ◽

pp. 174-181 ◽

Cited By ~ 1

Author(s):

Charles Ugwoke Eze ◽

Queendaline Ebere Onwuzu ◽

Innocent Uchechukwu Nwadike

Keyword(s):

Reference Values ◽

Gestational Age ◽

Head Circumference ◽

Outer Margin ◽

Menstrual Period ◽

Last Menstrual Period ◽

Abdominal Circumference ◽

Femur Length ◽

Biparietal Diameter ◽

Nigerian Population

This study aimed to establish reference values of fetal transverse cerebellar diameter (TCD) in a Nigerian population. A cross-sectional convenience study was carried out between June 2013 and May 2014 in Enugu, Nigeria. The sonographic examinations were performed on 697 pregnant women with gestational ages between 14 and 40 weeks. The TCD measurements were obtained from the proximal outer margin to the distal outer margin of cerebellum. The women’s last menstrual period, femur length, biparietal diameter, head circumference, and abdominal circumference were also recorded. The mean (standard deviation) TCD increased from 13.6 (2.2) mm to 27.3 (2.6) mm and 28.9 (2.0) mm to 42.9 (2.0) mm in the second and third trimesters, respectively. The relationship of TCD with gestational age obtained from last menstrual period, femur length, biparietal diameter, head circumference, and abdominal circumference was determined. The TCD had a strong correlation with gestational age ( r = .93; P < .05). Reference values for TCD were established for those patients who attended this clinic. This is a likely data set to use for future research that could focus on similar practices and in other regions of the country for possible generation of a nationwide nomogram.

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Estimation of gestational age by last menstrual period, by ultrasound scan and SPl concentration: comparisons with date of delivery

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.1986.tb08045.x ◽

1986 ◽

Vol 93 (6) ◽

pp. 649-650 ◽

Cited By ~ 1

Author(s):

Marion H. Hall

Keyword(s):

Gestational Age ◽

Menstrual Period ◽

Last Menstrual Period ◽

Ultrasound Scan

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Correlation of gestational age assessed by last menstrual period and New Ballard’s Score in pre term babies

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20203164 ◽

2020 ◽

Vol 7 (8) ◽

pp. 1718

Author(s):

Krithika S. ◽

Rajanish K. V. ◽

Adarsh E.

Keyword(s):

Gestational Age ◽

Critical Factor ◽

Menstrual Period ◽

Last Menstrual Period ◽

Normal Vaginal Delivery ◽

Management Decision ◽

New Born ◽

Medical College ◽

Management Decision Making ◽

One Year

Background: Gestational age is a critical factor in the management, decision making and follow up of new born infants. Identification of gestational age especially within 48 hours of life is crucial for new born. Since decades attempts have been made to find an alternative measurement for gestational age and birth weight estimation of the newborns. Last menstrual period is an inexpensive method and potentially efficient for calculating gestational age. Objective of this study was to the present study aims to compare the gestational age by New Ballards score with LMP, in pre term babies.Methods: A total 150 pre term babies who are born to mothers remembering LMP were enrolled for the study group. During the study period new Ballard scoring was done for babies within 48hrs and Gestational age was compared with LMP. The collected data was analyzed by using SAS-6.50 version. Study design a prospective observational study was conducted over a period of one year from January 2018 till December 2018 at Rajarajeswari Medical College and Hospital, Bengaluru, IndiaResults: The New Ballard score is found to be significantly correlated with GA above 29 weeks (p<0.01). The LMP mean was 35±2.0 weeks. Total 60.6 % of the childbirth is lead to normal vaginal delivery. The analysis shows LMP were found to be strongly correlated with GA (p<0.01).Conclusions: LMP alone can be reliably used in assessing the gestational age and can be assessed more accurately and be confirmed with new Ballard’s scoring for preterm babies of >29 weeks.

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