Biparietal diameter vs crown-rump length as standard parameter for late first-trimester pregnancy dating.

IF 6.1 1区 医学 Q1 ACOUSTICS Ultrasound in Obstetrics & Gynecology Pub Date : 2024-10-24 DOI:10.1002/uog.29124
H K Gjessing, P Grøttum, J M Dreier, S H Eik-Nes
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Abstract

Objective: To compare the precision of biparietal diameter (BPD) and crown-rump length (CRL) as predictors of gestational age in the human fetus in the late first and early second trimesters, using a population-based approach.

Methods: We constructed term and gestational-age prediction curves for first-trimester dating, based on 11 041 pregnancies with 12 260 measurements of CRL and/or BPD from a population-based Norwegian clinical database. We used a population-based approach with local linear quantile regression, combined with a time-to-event strategy that compensates for induced births. Term prediction precision was assessed by estimating and comparing the prediction residual curves using a time-to-event analysis. Individual differences in gestational-age predictions from CRL and BPD were assessed using measurements performed on the same fetus on the same day. A sensitivity analysis was performed to evaluate the effect of not distinguishing between non-spontaneous and spontaneous births.

Results: CRL and BPD provided almost identical term prediction precision judged from the residual distribution. In about 51% of examinations, the difference in predicted gestational age was 1 day or less; 24% of examinations had a difference of 2 days, 14% had a difference of 3 days, 7% had a difference of 4 days and only 5% of all examinations had a difference of 5 days or more. Incorrectly removing induced births from the analysis, or treating them as spontaneous, would cause a substantial systematic prediction bias of about 2 days.

Conclusions: Based on population data, using comparisons at an individual level, our study found that BPD is as precise as CRL when used for first-trimester dating. BPD has advantages from a clinical point of view, since it is technically less challenging and less time-consuming to measure compared with CRL, and can be measured and assessed throughout the entire pregnancy. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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双顶径与冠状脊长度的比较,作为第一胎晚期妊娠测定的标准参数。
目的比较双顶径(BPD)和冠臀长(CRL)作为人类胎儿在妊娠前三个月晚期和后三个月早期的孕龄预测指标的精确性:我们根据挪威人口临床数据库中 11 041 例妊娠和 12 260 次 CRL 和/或 BPD 测量结果,构建了第一孕期的足月和胎龄预测曲线。我们采用了基于人群的局部线性量化回归方法,并结合补偿引产的时间到事件策略。通过时间到事件分析来估计和比较预测残差曲线,从而评估了预产期预测精度。通过对同一天的同一胎儿进行测量,评估了 CRL 和 BPD 预测胎龄的个体差异。进行了一项敏感性分析,以评估不区分非自然分娩和自然分娩的影响:结果:从残差分布来看,CRL 和 BPD 提供了几乎相同的足月预测精度。在约 51% 的检查中,预测胎龄的差异为 1 天或更小;24% 的检查差异为 2 天,14% 的检查差异为 3 天,7% 的检查差异为 4 天,只有 5% 的检查差异为 5 天或更多。如果不正确地将引产从分析中剔除,或将其视为自然分娩,则会造成约 2 天的严重系统性预测偏差:我们的研究基于人口数据,通过个体水平的比较发现,BPD 与 CRL 在用于第一胎测算时同样精确。从临床角度来看,BPD 具有优势,因为与 CRL 相比,BPD 的测量技术难度更低,耗时更少,而且可以在整个孕期进行测量和评估。© 2024 作者。妇产科超声》由 John Wiley & Sons Ltd 代表国际妇产科超声学会出版。
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来源期刊
CiteScore
12.30
自引率
14.10%
发文量
891
审稿时长
1 months
期刊介绍: Ultrasound in Obstetrics & Gynecology (UOG) is the official journal of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and is considered the foremost international peer-reviewed journal in the field. It publishes cutting-edge research that is highly relevant to clinical practice, which includes guidelines, expert commentaries, consensus statements, original articles, and systematic reviews. UOG is widely recognized and included in prominent abstract and indexing databases such as Index Medicus and Current Contents.
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