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Journal of Obstetrics and Gynaecology Research, 2011
Clinical guidelines for obstetrical practice were first published by the Japan Society of Obstetrics and Gynecology (JSOG) and the Japan Association of Obstetricians and Gynecologists (JAOG) in 2008, and a revised version was published in 2011. The aims of this publication include the determination of current standard care practices for pregnant women in Japan, the widespread use of standard care practices, the enhancement of safety in obstetrical practice, the reduction in burdens associated with medico-legal and medico-economical problems, and a better understanding between pregnant women and maternity-service providers. These guidelines include a total of 87 Clinical Questions followed by several Answers (CQ&A), a Discussion, a List of References, and some Tables and Figures covering common problems and questions encountered in obstetrical practice. Each answer with a recommendation level of A, B or C has been prepared based principally on "evidence" or a consensus among Japanese obstetricians in situations where "evidence" is weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 87 CQ&As are presented herein to promote a better understanding of the current standard care practices for pregnant women in Japan.
Dating and growth in the first trimester
Best practice & research. Clinical obstetrics & gynaecology, 2009
j o ur n a l ho m e pa g e : w w w. e l se v i e r . co m / l o ca t e / b po b g y n 1521-6934/$ -see front matter Ó
Prediction of delivery date by sonography in the first and second trimesters
Ultrasound in Obstetrics and Gynecology, 2006
Objective To compare the dates of delivery predicted by last menstrual period (LMP), crown-rump length (CRL) and biparietal diameter (BPD) with the actual date of delivery in a population of pregnant women divided into those with certain and those with uncertain LMP.
BJOG: An International Journal of Obstetrics and Gynaecology, 2000
Objective To assess the association between gestational age estimated from the last menstrual period (GAL,,) or from the biparietal diameter (GAB,), and the subsequent birthweight for gestational age. Design Population-based follow up study. Setting Of 2 1,936 pregnancies contained in the ultrasound database, 16,387 singleton pregnancies with a reliable last menstrual period date and an ultrasound examination between 12 and 22 weeks of gestation were included. Main outcome measures Correlation between: 1. birthweight deviation (birthweight-expected weight for gestation); 2. birthweight; and 3. pregnancy length and (GALMp-GABpD). Relative risk of birthweight < 2500 g and low birthweight for gestation (> 22% below normal weight) related to five levels of discrepancy between (GALMp4ABpD). (GALMp-GABpD) was not associated with deviation of birthweight related to GAB, , However the risk of low birthweight (c 2500 g) and low birthweight for gestational age was significantly increased when (GAmp-GABpD) was > 7 days. Conclusion A biparietal diameter smaller than expected from the last menstrual period date is mainly a problem of an error related to estimated time of ovulation. At the same time the relative risk of a low birthweight infant is slightly increased. Results 238 ORCOG2000 BJOG 18 Mongelli M, Gardosi I. Birthweight, prematurity and accuracy of ges-181 7-1 822.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2013
Background The classical method of determining gestational age is from the last menstrual period (LMP). Uncertainty of LMP data (including digit preference-that is, women reporting LMP favour dates ending with 0 or 5-and the possibility that early pregnancy bleeding has been mistaken for menstruation) sometimes makes this method uncertain. In most developed countries, gestational age is nowadays estimated from fetometry performed before gestational week 20. Studies have, however, pointed out some limitations of this method also [1-3]. The possibility of using data from assisted reproduction for the validation of gestational age assessment methods was recently discussed [4] and has been used by some studies of limited size [5-9]. A slightly shorter mean gestational age was found when estimated from fetometry than when based on the date of embryo transfer but the difference was only 0.9-2.1 days or 1.9-2.1 days in singletons [8,9]. Similar results were obtained in a study of 72 infertile women with known ovulation date, using crown-rump length estimates [10]. One study of early fetometry found a better agreement between estimated age and true age when based on biparietal diameter (BPD) than when based on crown-rump length (CRL) [11] but another found no marked difference [9]. We used a large number of infants born after in vitro fertilization (IVF) with known length of embryo culture, date of embryo transfer and date of delivery, and with information on gestational duration estimated by fetometry. The material was large enough to investigate the possible effect of some maternal and fetal variables on the validity of the fetometric determinations.
Construction of modern Australian first trimester ultrasound dating and growth charts
Journal of Medical Imaging and Radiation Oncology, 2008
Accurate pregnancy dating is vital to obstetric management. However, first trimester fetal charts commonly used in Australia rely on data reported more than three decades ago. This study reports first trimester dating and growth charts for crown-rump length between 5 and 14 weeks of gestation and biparietal diameter between 9 and 14 weeks of gestation on an Australia population using modern real-time ultrasound equipment. All consenting eligible women attending a large Sydney clinic for first trimester ultrasound between March 2005 and December 2006 were recruited. Measurements were carried out to Australasian Society for Ultrasound in Medicine standard protocols. Statistical analyses were undertaken using polynomial regression models and thorough diagnostic checks made. Overall 396 eligible women consented to the study, with 268 between 9 and 14 weeks of gestation. The average participant age was 34 years (range 22-45 years), 371 and all yielded valid biometry measurements. Equations, means and 90% reference intervals for crown-rump length measurements and biparietal diameter measurements were derived using polynomial regression models. Thorough residual and diagnostic checks were made. Once validated by others, we believe they will warrant consideration for use by Australasian Society for Ultrasound in Medicine.