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Determining Date of Conception

Because human eggs capable of fertilization is only 12 to 24 hours after ovulation ovulation date can be taken as the date of conception. However, ultrasound determination have the same date of ovulation incorrectness as well as ultrasound estimate of pregnancy and, therefore, the exact date of conception can usually not be determined as in vitro fertilization.

In addition, although a woman most the possibility of pregnancy if he has sex on the day of ovulation conception can occur from still live sperm in the reproductive tract on the day of ovulation if she has sex five days before ovulation [26,27].

Determine Estimated Due Date

The estimated maturity (EDD or EDC) is the date spontaneous onset of labor is expected to occur. The maturity date can be estimated by adding 280 days (9 months and 7 days) for the first day of the last menstrual period (LMP). This is the method used by the "wheel of pregnancy". That EDD obtained the accuracy of this method depends on accurate recall by Mother, assuming normal cycle of 28 days, and that ovulation and conception occur on the 14th day of cycles. Use of LMP to set a due date may be overstating the duration of the pregnancy, and may be subject to more errors than 2 weeks [5-7].

In cases where the conception date precisely known, as with in vitro fertilization, the EDD is calculated by adding 266 days the date of conception.

using ultrasound to determine fetal size gestational age (time elapsed since the first day of the last menstrual period Point). Ultrasound forecast accuracy of gestation varies according to gestational age. "Ultrasound measurements of the embryo or fetus in the first trimester (up to and including 13 6/7 weeks gestation) is The most accurate method to establish or confirm the gestational age "[24] .the Society of Obstetricians and Gynecologists of Canada recommends early Ultrasound with crown rump length equivalent to at least 7 weeks (or 10 mm) should be used to determine gestational age [28].

American College of Obstetricians and Gynecologists recommends that ultrasound-established date should take preference over menstrual date when the difference between LMP and ultrasound dating is

"Because the risk of re-dating the little fetus that may restricted growth, management decisions based on the three trimesters A particularly problematic ultrasound; they need to be guided by careful consideration of the whole clinical picture and may require closer supervision, including repeat ultrasound to ensure the proper hose growth. "[24].

Other Methods For Estimating Gestational Age clinical examination A pelvic examination is supported by a good record of menstruation in the first trimester has been reported to be a reliable method for dating the pregnancy [9]. Doppler Ultrasound The fetal heart can be heard using a Doppler ultrasound by 10 to 12 weeks in most patients [10]. Gestational age must, therefore, at least 10 to 12 weeks if fetal heart tones sounded. Human Chorionic Gonadotropin Pregnancy Test Human chorionic gonadotropin first become detectable in the blood of mothers and urine between 6 and 14 days after fertilization (3 to 4 weeks of gestation) [11-13]. The gestational age would, therefore, at least 3 to 4 weeks when the hCG pregnancy test reliable.

twin When a twin pregnancy is the result of in vitro fertilization determination pregnancy must be made from the date of embryo transfer. If it is not "... to avoid missing early intrauterine situation restrictions on growth in one of twins, most experts agree that doctors might consider dating a pregnancy using large fetuses. "[22,23].

Observed Gestational Age at Delivery

The table below shows the average age of babies born in the United States according to the number of fetuses being carried out (plurality) [29].

Earlier age at delivery of twin pregnancies is a reflection of an increased incidence of premature labor and obstetric interventions for complications such as preeclampsia, placental abruption, fetal growth restriction, and mencreased risk for stillbirth that occurred as the number of fetuses increases [30-33]. The tendency for some pregnancies be delivered earlier than the single Pregnancy should not be construed that the multiplier must be assigned previously estimated due date. A full-term pregnancy is considered 39-40 6/7 weeks regardless of the number fetus being carried out [34].

1. Chervenak FA, Skupski DW, Romero R, et al: How accurate are fetal biometry in the assessment of fetal age?. Am J Obstet Gynecol 1998; 178: 678. 2. Mongelli M, Wilcox M, Gardosi J.: Estimating the date of confinement: biometery ultrasonography vs certain menstrual dates. Am J Obstet Gynecol 1996; 174: 278. 3. Savitz DA, Terry Jr JW, Dole N, et al: Comparison of dating pregnancies last menstrual period, ultrasound scanning, and their combinations. Am J Obstet Gynecol 2002; 187: 1660. 4. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologist. No. 55, September 2004 (Replaces practice number patterns October 6, 1997). Postterm Management Pregnancy.Obstet Gynecol. 2004; 104: 639-46. 5. Kramer MS, McLean FH, Boyd ME, Usher RH: Validity of gestation estimates by menstrual dating in term pregnancy, premature and postterm. JAMA 1988; 260: 3306. 6. Savitz DA, Terry JW Jr, N Dole, Thorp JM Jr, Siega-Riz AM, Herring AH.Comparison dating of pregnancy with last menstrual period, ultrasound scanning, and their combinations. Am J Obstet Gynecol. 2002 December; 187 (6): 1660-6. 7.Wilcox M, Gardosi J, Mongelli M, et al. Birthweight of pregnancy dates by ultrasonography in multicultural UK population. BMJ. 4 Sep 1993; 307 (6904): 588-91. 8. Ultrasound in Pregnancy. ACOG Practice Bulletin No. 98. American College of Obstetricians and Gynecologists. Obstet Gynecol 2008; 112: 141 944. 9. Rossavik IK, Fishburne JI. conceptional age, the age of menstruation, and USG Age: comparison of second trimester of pregnancy from conception date is known Pregnancy date of the last menstrual period. Obstet Gynecol. 1989 February; 73 (2): 243-9.PMID: 2643067 10. SO Henderson, Mallon WK.Trauma in pregnancy. Emerg Med Clin North Am. 1998 February; 16 (1): 209-28.PMID: 9496322 11. Hay DL, Lopata A.Chorionic gonadotropin secretion by the human embryo vitro. J Clin Endocrinol Metab. 1988 December; 67 (6): 1322-4.PMID: 2461389 12. Wilcox AJ, et al. When implantation of the conceptus and loss pregnancy.N Engl J Med. 1999 June 10, 340 (23): 1796-9. 13. Lohstroh P, et al. Daily immunoactive and bioactive human chorionic profile periimplantation gonadotropin in urine samples. Biol Reprod. 2006 July; 75 (1): 24-33. 14. The cervical insufficiency. ACOG Practice Bulletin No. 48. American College of Obstetricians and Gynecologists. Obstet Gynecol 2003; 102: 10 919. 15. Berghella V, et al., Is the transvaginal sonographic measurement of cervical Long before 14 weeks predict preterm delivery in high-risk pregnancies? Ultrasound Obstet Gynecol 2003; 21: 140-144. 16. Ultrasound in Pregnancy. ACOG Practice Bulletin No. 101. American College of Obstetricians and Gynecologists. Obstet Gynecol 2009; 113: 45 161. 17. ACOG practice bulletin. Prevention of Rh D alloimmunization. Number 4, May 1999 (Replaces education newsletter No. 147, October 1990). clinical management guidelines for obstetrician-gynecologist. The American College of Obstetrics and Gynecology. Int J Gynaecol Obstet. 1999 July; 66 (1): 63-70. 18. Fetal pulmonary maturity. ACOG Practice Bulletin No. 97. American College of Obstetricians and Gynecologists. Obstet Gynecol 2008; 112: 71 726 19. ACOG practice bulletin. Antepartum fetal surveillance. Number 9, October 1999 (Replaces the Technical Bulletin No. 188, January 1994). clinical management guidelines for obstetrician-gynecologist. Int J Gynaecol Obstet. February 2000; 68 (2): 175-85. 20. Institute for Clinical System Improvement. Routine Prenatal Care. 13 ed. August 2009. Available at: 21. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 101: Ultrasound in pregnancy. Obstet Gynecol. February 2009; 113 (2 Pt 1): 451-61. 22.Morin L, Lim K. ultrasound in twin pregnancies. J Obstet Gynaecol Can. 2011 June; 33 (6): 643-56. PMID: 21846456 23. Sperling L, Tabor A.Twin pregnancy: the role of ultrasound in management.Acta Obstet Gynecol Scand. 2001 April; 80 (4): 287-99. 24. The method for estimating the maturity date. Committee Opinion No. 611. Ameri-cans College of Obstetricians and Gynecologists. Obstet Gynecol 2014; 124: 8636. 26.Allen J Wilcox, David Dunson, and Donna Day Baird. Time "fertile window" in the menstrual cycle: a certain day forecast of a prospective study BMJ 2000; 321: 1259-1262. 27. Wilcox AJ, Weinberg CR, Baird DD.Timing sexual intercourse in relation to ovulation. The effect on the chances of conception, survival of the pregnancy, and sex of the baby. N Engl J Med. 1995 December 7; 333 (23): 1517-1521. 28. Determining Gestational Age by ultrasound No. 303, February 2014 Society of Obstetricians and Gynecologists of Canada.J Obstet Gynaecol Can 2014; 36 (2): 171 181 29. Martin JA, et al, Birth :. Data late 2009. , Natl Vital Stat Rep 2011 November 3; 60 (1): 1-70. http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf 30. multifetal pregnancy: twins, triplets, and higher levels of pregnancy multifetal. Practice Bulletin No. 144. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014; 123: 111 832. 31.Page JM, The risk of stillbirth and infant mortality by each additional week expectant management in twin pregnancies. Am J Obstet Gynecol. 2015 as May; 212 (5): 630.e1-7. doi: 10.1016 / j.ajog.2015.03.033. Epub 2015 March 19 32.Burgess JL, ER Unal, Nietert PJ, Newman RB.Risk late-preterm stillbirth and neonatal morbidity and dichorionic for monochorionic twins. Am J Obstet Gynecol. 2014 June; 210 (6): 578.e1-9. doi: 10.1016 / j.ajog.2014.03.003. Epub 2014 March 5. 33. Kahn B, et. al, the risk of fetal death Candidates in single, twin and triplet pregnancies :. implications for practice. Obstet Gynecol. 2003 October; 102 (4): 685-92. P 34. The definition of term pregnancy. Committee Opinion No. 579. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013; 122: 113 940

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