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23 Mar

In cases where the date of conception is known precisely, such as with in vitro fertilization, the EDD is calculated by adding 266 days to the date of conception. American College of Obstetricians and Gynecologists. Ultrasound uses the size of the fetus to determine the gestational age (the time elapsed since the the first day of the last menstrual period). Page JM, The risk of stillbirth and infant death by each additional week of expectant management in twin pregnancies. Risk of late-preterm stillbirth and neonatal morbidity for monochorionic and dichorionic twins. Other Methods For Estimating the Gestational Age Clinical Examination A pelvic examination supported by good menstrual records in the first trimester has been reported to be a reliable method for dating of pregnancy [9]. Doppler Ultrasonography The fetal heart can be heard using Doppler ultrasound by 10 to 12 weeks in most patients [10]. Savitz DA, Terry JW Jr, Dole N, Thorp JM Jr, Siega-Riz AM, Herring AH. The Society of Obstetricians and Gynaecologists of Canada recommends the earliest ultrasound with a crown rump length equivalent to at least 7 weeks (or 10 mm) should be used to determine the gestational age [28].

Berghella V, et al., Does transvaginal sonographic measurement of cervical length before 14 weeks predict preterm delivery in high-risk pregnancies? The timing of the "fertile window" in the menstrual cycle: day specific estimates from a prospective study BMJ 2000; 321: 1259-1262. Effects on the probability of conception, survival of the pregnancy, and sex of the baby. Timing of sexual intercourse in relation to ovulation. Otherwise "..avoid missing a situation of early intrauterine growth restriction in one twin, most experts agree that the clinician may consider dating pregnancy using the larger fetus." [22,23]. Observed Gestational Age at Delivery The table below shows the average age of infants delivered in the United States according to the number of fetuses being carried (plurality) [29]. Savitz DA, Terry Jr JW, Dole N, et al: Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination.