Obstetric dating criteria

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Obstetric ultrasonography , or prenatal ultrasound , is the use of medical ultrasonography in pregnancy , in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus womb. The procedure is a standard part of prenatal care in many countries, as it can provide a variety of information about the health of the mother, the timing and progress of the pregnancy, and the health and development of the embryo or fetus. The International Society of Ultrasound in Obstetrics and Gynecology ISUOG recommends that pregnant women have routine obstetric ultrasounds between 18 weeks' and 22 weeks' gestational age the anatomy scan in order to confirm pregnancy dating, to measure the fetus so that growth abnormalities can be recognized quickly later in pregnancy, and to assess for congenital malformations and multiple pregnancies twins, etc. Performing an ultrasound at this early stage of pregnancy can more accurately confirm the timing of the pregnancy, and can also assess for multiple fetuses and major congenital abnormalities at an earlier stage.
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First trimester | Radiology Reference Article | sria.info

Redating a pregnancy may occur when there is a discrepancy between the estimated due date EDD calculated by the last menstrual period LMP and that by ultrasound. Care should be taken when redating a pregnancy, especially in the third trimester, as there may be other reasons for a fetus to be small for gestational age e. According to the ACOG redating is more reliable using the earliest available and reliable ultrasound examination surrogates. For instance, CRL in the first trimester would be more accurate than a debatable uncertain LMP or 2nd-trimester biometrics.
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Guideline Summaries

Because the human egg is capable of fertilization for only 12 to 24 hours after ovulation the date of ovulation may be taken as being the date of conception. 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. In addition, although a woman is most likely to become pregnant if she has sex on the day of ovulation conception may also occur from live sperm still in her reproductive tract on the day of ovulation if she had sex for up to five days before ovulation [26,27].
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Tremendous advances have been made in healthcare during pregnancy and child birth. From basic check-ups to advanced screenings, obstetrical procedures strive to ensure the safety and health of both the mother and the baby. Women planning to have a baby can start their medical check-ups pre conception and continue with regular check-ups right through the course of their pregnancy and after. Depending on the advice of the doctor, procedures to check on the health of the fetus may include Doppler velocimetry, ultrasound, echocardiography, Doppler umbilical scan, Doppler cerebral artery scanning etc. While both regular pregnancy and maternal-fetal screening tests are used to check on the health of the mother and the fetus during the course of the pregnancy and post delivery, there is a significant difference between the CPT codes used for billing the procedures and services performed.
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