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Obstetrics & Gynecology 1983;61:438-443
© 1983 by The American College of Obstetricians and Gynecologists
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Clinical Measures of Gestational Age in Normal Pregnancies

JUAN M. JIMENEZ, MD, JON E. TYSON, MD and JOAN S. REISCH, PhD

From the Departments of Obstetrics and Gynecology, Pediatrics, and Medical Computer Science, University of Texas Health Science Center, Dallas, Texas

Abstract

Obstetric findings in 89 healthy women were evaluated prospectively by one obstetrician unaware of menstrual history. With weekly examinations, fetal heart tones were audible by fetoscope at 17.1 ± 1.1 weeks' gestation (mean ± SD) and the fundus reached the umbilicus at 16.6 ± 0.9 weeks. At 20 to 31 weeks, fundal height in centimeters equaled weeks' gestation (confidence interval: ± 3 weeks). The accuracy of predicting delivery date from combined findings (SD: 11.4 days) approached that from reliable menstrual history (SD: 10.2 days). Gestational age at delivery minus the pediatric Dubowitz s 0.4 ± 1.7 weeks. Gestational age may be overestimated by up to six weeks by assuming that the fundus reaches the umbilicus or that fetal heart tones appear at 20 weeks. However, carefully derived obstetric estimates potentially may be more reliable than pediatric estimates.




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