How accurate are dating scans at 14 weeks

However, there is great usefulness in having a single, uniform standard within and between institutions that have access to high-quality ultrasonography as most, if not all, U.

What is the purpose of the dating scan?

Accordingly, in creating recommendations and the associated summary table, single-point cutoffs were chosen based on expert review. Because this practice assumes a regular menstrual cycle of 28 days, with ovulation occurring on the 14th day after the beginning of the menstrual cycle, this practice does not account for inaccurate recall of the LMP, irregularities in cycle length, or variability in the timing of ovulation.

It has been reported that approximately one half of women accurately recall their LMP 2—4. Accurate determination of gestational age can positively affect pregnancy outcomes. For instance, one study found a reduction in the need for postterm inductions in a group of women randomized to receive routine first-trimester ultrasonography compared with women who received only second-trimester ultrasonography 5. A Cochrane review concluded that ultrasonography can reduce the need for postterm induction and lead to earlier detection of multiple gestations 6.

Because decisions to change the EDD significantly affect pregnancy management, their implications should be discussed with patients and recorded in the medical record. Measurements of the CRL are more accurate the earlier in the first trimester that ultrasonography is performed 11, 15— The measurement used for dating should be the mean of three discrete CRL measurements when possible and should be obtained in a true midsagittal plane, with the genital tubercle and fetal spine longitudinally in view and the maximum length from cranium to caudal rump measured as a straight line 8, Mean sac diameter measurements are not recommended for estimating the due date.

Dating changes for smaller discrepancies are appropriate based on how early in the first trimester the ultrasound examination was performed and clinical assessment of the reliability of the LMP date Table 1. For instance, the EDD for a pregnancy that resulted from in vitro fertilization should be assigned using the age of the embryo and the date of transfer.

Your pregnancy and baby guide

For example, for a day-5 embryo, the EDD would be days from the embryo replacement date. Likewise, the EDD for a day-3 embryo would be days from the embryo replacement date. Using a single ultrasound examination in the second trimester to assist in determining the gestational age enables simultaneous fetal anatomic evaluation. With rare exception, if a first-trimester ultrasound examination was performed, especially one consistent with LMP dating, gestational age should not be adjusted based on a second-trimester ultrasound examination.

Ultrasonography dating in the second trimester typically is based on regression formulas that incorporate variables such as. Other biometric variables, such as additional long bones and the transverse cerebellar diameter, also can play a role.

Date changes for smaller discrepancies 10—14 days are appropriate based on how early in this second-trimester range the ultrasound examination was performed and on clinician assessment of LMP reliability. Because of the risk of redating a small fetus that may be growth restricted, management decisions based on third-trimester ultrasonography alone are especially problematic; therefore, decisions need to be guided by careful consideration of the entire clinical picture and may require close surveillance, including repeat ultrasonography, to ensure appropriate interval growth.

The best available data support adjusting the EDD of a pregnancy if the first ultrasonography in the pregnancy is performed in the third trimester and suggests a discrepancy in gestational dating of more than 21 days. As soon as data from the LMP, the first accurate ultrasound examination, or both are obtained, the gestational age and the EDD should be determined, discussed with the patient, and documented clearly in the medical record.

For the purposes of research and surveillance, the best obstetric estimate, rather than estimates based on the LMP alone, should be used as the measure for gestational age. The American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal—Fetal Medicine recognize the advantages of a single dating paradigm being used within and between institutions that provide obstetric care.

Table 1 provides guidelines for estimating the due date based on ultrasonography and the LMP in pregnancy, and provides single-point cutoffs and ranges based on available evidence and expert opinion. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

The signed consent form and a data collection sheet were attached to the referral form. Prior to commencing the scan, sonographers ensured the consent form was complete and provided an opportunity for further information or clarification. The ultrasound was then conducted in the usual manner. At the conclusion of each scan, when the woman had left the room, sonographers completed the data collection form. The form contained simple options enabling the sonographer to complete it quickly and easily by placing a cross in the appropriate boxes.

The form indicated the attending sonographer, pertinent patient details, age of fetus, gender prediction, reason for a failure to predict gender if applicable and the woman's desire to know gender. Once complete, the data collection form was sealed in an envelope and securely stored with the expected delivery date and place of delivery recorded on the front. After the delivery date had passed, the phenotypic gender was sought and recorded on the data sheet.

The birth gender was obtained through hospital records or by direct phone contact with women. Fetuses in the second and third trimesters were scanned in either transverse or sagittal planes at the discretion of the attending sonographer. Prior to the study, sonographers were instructed to view the genital area of first trimester fetuses in a sagittal view only. A caudally directed tubercle was to be recorded a female, a cranial directed tubercle was recorded as a male, using the same technique described by Emerson, et al. During the study period, scans were performed on a total of fetuses.

Third trimester gender predictions were made on fetuses, including one twin pregnancy. Two hundred and fifteen fetuses were included in the second trimester group including five twin pregnancies. The first trimester group included fetuses of which there were three twin pregnancies. Gestational age was calculated from either LMP, a previous dating scan or taken from referral details. All data was entered and tabulated using the Microsoft Excel program.

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The three trimester groups were entered separately to allow for individual analysis. Of the fetuses, Only one fetus was excluded from the study due to ambiguous genitalia and other anomalies Trisomy 21 was confirmed on invasive testing.

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Phenotypic gender was confirmed for all study participants. Increased maternal body mass index BMI and unfavourable fetal lie contributed to the two fetuses without gender assignment.

Dating scan accuracy?!

Correct gender assignment was achieved in all remaining fetuses. Gender assignment was possible in of In one case the gender could not be determined due to increased maternal BMI, uterine fibroids and unfavourable fetal lie. Correct gender was achieved in all remaining fetuses. Results were significantly different for the first trimester group. In the majority of cases the reasons for inability to predict gender included unfavourable lie and increased maternal BMI. The full results of the first trimester group are shown in Table 1. The above table demonstrates how accuracy rates improved with advancing gestational age.

Fetuses between 12—12 weeks 6 days, demonstrated a high degree of accuracy in predictions. Although only a small number of fetuses were examined between 14 weeks and 16 weeks, all were correctly predicted. The feasibility rate of making predictions was relatively stable through each of the groups. Predictive errors were more common in young male fetuses. Male fetuses under 12 weeks gestation were correctly predicted Gender specific differences are highlighted in Table 2.

The remaining four sonographers attended 28 ultrasound scans or more.

week pregnancy dating scan - NHS

This result was also lower than several other studies. Firstly, this study included predictions made by sonographers with varying levels of experience. Secondly, the practice where this study was attended has a policy allowing support people and their children to attend ultrasounds. Consequently, sonographers often deal with multiple distractions.

In studies where predictions were made by researchers away from the clinical setting, 5 , 6 , 10 , 11 these factors would be negated.

14 weeks 2D ultrasound Can you tell the gender ? it´s a girl Rafael Ortega Muñoz MD Gynecologist

The study conducted by Whitlow, et al. It must also be noted that the study did not allow for an increase in scan time and many parents did not wish to know the gender of their fetus. Some prediction errors may have been made as a result of time constraints or by sonographers attempting to minimising parents viewing the fetal genital area. This study demonstrated a strong correlation between fetal age and accuracy rates of gender predictions.

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Comparable results were noted in other studies. The study by Hsiao, et al. Success rates rose from Feasibility rates in this study were not found to be affected by gestational age. These results were not reflected in other studies. Results of this study indicate that more errors occur with young male fetuses than young female fetuses. The accuracy of predicting males compared to females has shown conflicting results in previous studies.

Several studies 12 — 15 found significant differences between success rates of predicting male fetuses. Younger males were predicted incorrectly more commonly. Find out more about what happens during a pregnancy ultrasound scan. Some abnormalities may also be detected at this scan, such as neural tube defects spina bifida is a type of neural tube defect. Screening for Down's syndrome will happen at the dating scan if:. The screening test for Down's syndrome used at this stage of pregnancy is called the "combined test".

It involves a blood test and measuring the fluid at the back of the baby's neck nuchal translucency with an ultrasound scan.

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This is sometimes called a nuchal translucency scan. The nuchal translucency measurement can be taken during the dating scan. Find out more about the combined screening test for Down's syndrome. You won't be offered the combined screening test if your dating scan happens after 14 weeks. Instead, you will be offered another blood test between 14 and 20 weeks of pregnancy to screen for the risk of Down's syndrome.