New charts for ultrasound dating of pregnancy
The tendency for multiple gestations to be delivered earlier than singleton pregnancies should not be interpreted that multiples should be assigned an earlier estimated due date.
A full term pregnancy is considered to be 39 to 40 6/7 weeks regardless of the number fetuses being carried . Chervenak FA, Skupski DW, Romero R, et al: How accurate is fetal biometry in the assessment of fetal age?
Twins When a twin pregnancy is the result of in vitro fertilization determination of gestational age should be made from the date of embryo transfer. Clinical management guidelines for obstetricians-gynecologists. Number 55, September 2004 (replaces practice pattern number 6, October 1997).
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].
Berghella V, et al., Does transvaginal sonographic measurement of cervical length before 14 weeks predict preterm delivery in high-risk pregnancies?
American College of Obstetricians and Gynecologists.
However, ultrasound determination of the date of ovulation has the same imprecision as does the ultrasound estimate of the gestational age and, therefore, a precise date of conception cannot usually be determined as with in vitro fertilization.
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 .
The American College of Obstetricians and Gynecologists recommends that ultrasound-established dates should take preference over menstrual dates when the discrepancy between ultrasound dating and LMP is "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; they need to be guided by careful consideration of the entire clinical picture and may require closer surveillance, including repeat ultrasonography to ensure appropriate interval growth." . Birth weight from pregnancies dated by ultrasonography in a multicultural British population.