Overview
Dates First: Gestational Age Sets the Frame
Gestational age is the ruler used for every fetal weight, milestone, percentile and viability decision.
Gestational age is the ruler used for every fetal weight, milestone, percentile and viability decision. If the ruler is wrong, a normally growing fetus can be labelled too small, or a growth-restricted fetus can appear deceptively appropriate. Pregnancy is conventionally dated from the first day of the last menstrual period (LMP). By that convention, the first trimester is approximately weeks 1 to 13 or 14, the second is approximately weeks 14 to 27 or 28, and the third begins around week 28. Fertilisation usually occurs about 2 weeks after LMP dating begins. The embryonic period spans roughly the third to eighth week after conception, or approximately 5 to 10 weeks by LMP dating. From about the ninth or tenth week of development onward, the conceptus is termed a fetus. When dates are uncertain, first-trimester ultrasound is preferred. An ultrasound between 7 and 14 weeks, ideally between 7 and 12 weeks, provides the most reliable dating. Crown-rump length is the most accurate parameter and is used up to 84 mm; beyond 84 mm, biparietal diameter is used. A later scan should...
