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The pregnant population and a fetal crown-rump length screening program
Ultrasound screening for estimation of gestational age is one of the most important advances made in obstetrics. In this study on the effects of our crown-rump length (CRL) screening program, a most significant (25%) proportion of the pregnant women had a difference between menstrual age and gestational age estimated on the basis of crown-rump length, exceeding 7 days. Regular menstrual cycles and reliable menstrual history could only reduce this frequency to 19%. Postmature deliveries (greater than 294 days menstrual age) were reduced from one in fifteen to one in three hundred. A screening program with CRL is useless if the woman books in too late, since a CRL above 90 mm is unreliable because of differences in fetal bending of the spine. In our catchment area more than 78% of the women delivered booked early enough for a fetal CRL measurement. If this result can be expected in a population, CRL measurement should be used because of its better accuracy than biparietal diameter measurement for the estimation of gestational age.
Ultrasound screening for estimation of gestational age is one of the most important advances made in obstetrics. In this study on the effects of our crown-rump length (CRL) screening program, a most significant (25%) proportion of the pregnant women had a difference between menstrual age and gestational age estimated on the basis of crown-rump length, exceeding 7 days. Regular menstrual cycles and reliable menstrual history could only reduce this frequency to 19%. Postmature deliveries (greater than 294 days menstrual age) were reduced from one in fifteen to one in three hundred. A screening program with CRL is useless if the woman books in too late, since a CRL above 90 mm is unreliable because of differences in fetal bending of the spine. In our catchment area more than 78% of the women delivered booked early enough for a fetal CRL measurement. If this result can be expected in a population, CRL measurement should be used because of its better accuracy than biparietal diameter measurement for the estimation of gestational age.