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CLINICAL NOTE
ASSESSMENT OF GESTATIONAL AGE IN THE
FIRST TRIMESTER OF PREGNANCY
BY MAXIMUM FETAL DIAMETER
J. HIGGINBOQOM,
J. SLATERand G. PORTER
University Hospital of South Manchester, Departments of Radiology. and of Obstetrics and Gynaecology. West
Didsbury, Manchester M20 8LR, England
(First received
in final
form 2 February
1977)
INTRODXTIOIQ
With the frequent use of induction of labour in
modern obstetrics, accurate knowledge of the
gestational age has become increasingly important,
especially in relation to the dysmature fetus, but
clinical methods are not always reliable particularly
with an uncertain menstrual history (Beazley and
Underhill, 1970).
Ultrasound provides the most satisfactory way
of measuring the fetus in ufero. Although the
biparietal diameter provides a reasonably accurate
method of estimating gestation age after the
fourteenth week of pregnancy (Campbell and
Newman, 1971), an earlier estimation is often very
useful; for the latter purpose, the most reliable
method so far described is that of Robinson (1973),
in which the so called crown-rump length of the
fetus is measured direct from a Polaroid photograph of the fetus as displayed on the oscilloscope. In patients with a reliable menstrual
history, Robinson achieved accuracy to within half
a week, but his technique is complex and time
consuming. In modifying it, we have established a
quicker and simpler procedure which is only
marginally less accurate.
It should be appreciated that this method can
only be used to estimate fetal age in the first
trimester of pregnancy and is different from our
technique to estimate fetal weight later in
pregnancy which is described elsewhere in Ulrrasound in Medicine and Biology (1977) (this issue,
p. 59). It is not possible to use the latter technique in
fetuses of less than 20 weeks.
hElEOD
The maximum fetal diameter is measured by B
mode sonar, using a Kretz L.M. 4100 M.G.S.
Fig. 2.
J. HIGGINBOTTOM
et al.
48
Number of
cases
22
224
:33t
1
7
11
5
1.5
10.8
17.0
7.7
24
244
25
254
26
26!
27
19
8
6
3
2
1
z
65
29.2
12.3
9.2
4.6
3.1
1.5
3.1
100.0%
Number of
cases
34I
Table 1. The mean value for maximum
fetal diameter/crown-rump length
Gestation (weeks)
M.F.D. (cm)
RESULTS
::t
2
41
3.1
6.2
1.5
13.8
15
10
9
3
2
-
23.1
15.4
13.8
4.6
3.1
37
374
38
384
39
34
40
0.7
1.0
1.5
2.2
3.0
4.2
5.5
6.5
6
7
8
9
10
11
12
13
L 15
100%
65
Number of cases
37$
38
38t
39
3%
1
2
2
6
11
1.5
3.1
3.1
9.2
16.9
z
41
15
17
7
23.1
26.2
10.8
Total
61
93.8
deviation
including
40 weeks,
Assessment of gestational age in the first trimester of pregnancy by maximum fetal dieter
Fig. I.
49
Assessment
of gestational
DlSCUMON
U.M.BYol 3. No 1-D
51
Acknowledgements-We
would like to thank Professor C. R.
Whitfield, Dr G. Hartley and Dr D. L. Asbury for encouragement
and advice; and Dr R. W. Burslem and Mr J. B. Jones whose
patients were included in this study.
rlmmRENcl?s