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Obstetrician Literature Review

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REVIEW OF THE LITERATURE:
The first and foremost duty of an obstetrician is to date the pregnancy as early as possible during the antenatal period.1,2 The accurate knowledge of the gestational age is a keystone in an obstetrician's ability to successfully manage the ante partum care of a patient and is of critical importance in ante-natal tests and successful planning of appropriate therapy or intervention,3 especially in high-risk pregnancies such as assessment of foetal growth and to schedule the labour date. Any inaccurate estimation may lead to perinatal morbidity and mortality due to iatrogenic prematurity or postmaturity.4 Traditionally the duration …show more content…

But labour may start even with long and closed cervix.
ULTRASOUND :12 In the modern obstetrics after the widespread use of the ultrasound dating the pregnancy and assessment of the gestational age by ultrasound has become the important component of obstetrics ultrasonography. Calculation of the gestational age by ultrasound biometric measurements is based on the size of the foetus or embryo in consistent with the age. During the first trimester the biological variation is found to be minimal when compared to the second and the third trimester. Hence first trimester estimation of the gestational age by ultrasound is more accurate. The parameters mainly seen in the transabdominal or transvaginal ultrasound to diagnose the gestational age in first trimester are mean gestational sac diameter, crown lump length and biparitel diameter.
TRANSABDOMINAL VERSUS TRANSVAGINAL …show more content…

It is measured by several measurement of CRL and its average or the best CRL is made.25 The accuracy of CRL is within 3 to 8 days.21,26-38The MSD is not used for measuring the gestational age once the CRL is measurable.21,38,40The CRL is measured by keeping the neck position in neutral and by taking the longest straight line length from the outer margin of the cephalic end to the rump.29,30,40The confidence interval lies between the 7 and 60mm for CRL.28,30,39 So the best measurability and reliability is seen when the CRL is atleast 10mm. If more than one scan is done in the first trimester the earlier scan CRL of more than 10mm is taken for dating the pregnancy.40-43 The threshold for estimating the gestational age as suggested by ISUOG is 84mm seems

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