مقارنة بين قياسات القطر بين الجداريين الجنيني BPD بفائق الصوت و تاريخ آخر دورة طمثية منتظمة LMP في توقع يوم الولادة في البدء العفوي للمخاض عند مواطنات سوريات

الملخص EN

Background & Objective: Most of Syrian pregnant women do not remember their LMP exactly, so that if there is another correct way (like BPD measurement by ultrasound), It may improve the obstetric management in clinical practice.

To compare between regular last menstrual period (LMP) and ultrasonographic Bi-Parietal Diameter (BPD) measurements in predicting delivery dates(EDD) in a Syrian population.

Materials & Methods: This was a prospective observational study of women with a normal spontaneously conceived viable singleton pregnancy, a regular menstrual cycles, and spontaneous onset of labor at term.

The LMP was considered certain in all cases.

We used ultrasound to scan 678 fetuses (678 Healthy women) at 13 - 416 weeks.

The BPD of each fetus was measured three times, the mean of which was used to derive the best-fit regression model for estimation of gestational age in relation to BPD.

Data were collected prospectively and used for statistical analysis.

The duration of pregnancy from the scan to the day of spontaneous delivery was predicted by BPD using regression model.

The accuracy of each method in predicting the day of delivery was determined.

The true delivery dates were compared with estimates based on LMP and BPD.

The results were represented as tables & diagrams.

RESULTS: The best-fit equation for the estimate of delivery date Yi from BPD (in mm) was: ' Yi =169.88 + 1.54(BPD); - 0.058(BPD);2 + 0.0002(BPD);3.

The mean of true gestational age at Delivery by LMP and that estimated by BPD was 275.2 ±8.1, 275.4 ± 11.7 days, respectively.

The Median was 276, 274.5 days respectively.

The Std.

Error & Std.Deviation was (0.3, 8.1) & (0.4, 11.7) days respectively.

The range of error of EDD estimated by BPD was (-27, 27) days.

The percentages of women in whom the EDD by LMP within 3 days (±3days),7 days (±7days), 14 days (±14days) of the true date of delivery were 32.7%, 56.3%, & 86.3% respectively.

The correspondent percentages for BPD were 23.7%, 44.5%, & 77.4 % respectively.

There was statistically important difference between the two methods (LMP is more accurate: Z = 10.48, P < 0.001), but it was of little clinical importance.

The LMP gave later estimates, while BPD gave earlier estimates from true Delivery dates.

CONCLUSIONS: in spite of LMP was more accurate in predicting the delivery date than BPD measurements, but in women who forget the exact LMP, we can rely on BPD measurements, because the differences were of little importance clinically.

KEYWORDS: Syrian women; last menstrual period (LMP); Bi-Parietal Diameter (BPD); expected date of delivery (EDD); ultrasound.