How To Know Due Date – This article was originally published in 2015 and was last updated by Rebecca Dekker (PhD, RN) and Anna Bertone (MPH) on November 24, 2019. Please read the disclaimer and terms of use. With a printable PDF, becoming a Professional Member gives you access to the entire library.
What is an estimated date and how is it determined? What are the risks of missing the deadline?
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This byline article focuses on evidence of due dates, including the accuracy of due dates, the risk of stillbirth at various gestational ages, and the risk factors that put some people at increased risk of stillbirth. Click here to read the specially signed article on (Benefits and Risks of Pre- and Post-Date Selective Adoption).
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For many years, babies were defined as “term” if they were born between 37 weeks 0 days and 41 weeks 6 days. Five weeks before this her is considered “pre-deadline” and five weeks after is considered “post-deadline”.
But as time went on, studies began to show that health problems were more common at certain points during those five weeks. more likely to die (although the overall risk is still very low).
Newborns are less likely to have problems if they are born between 39 weeks and her 0 days, and between 40 weeks and her 6 days (Spong, 2013).
In 2012, a group of experts met to define gestational age. Based on a review of research evidence, they divided her 5-week period into separate groups (Spong, 2013).
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Doctors, midwives, and online due date calculators use Negele’s Principle (here to hear it pronounced and find out your due date (EDD)).
Negele’s law assumes that the menstrual cycle is 28 days and the day of ovulation is exactly on the 14th day of the cycle (Note: If you have a long or short menstrual cycle, consult a medical provider to adjust your period due date. some people).
To calculate her EDD according to Naegele’s law, on the first day of her last period he added 7 days, then counted 9 months ago (or counted 3 months ago). This is equivalent to counting 280 days from your last menstrual period.
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For example, if her last period was April 4th, add 7 days (April 11th) and subtract 3 months = estimated date of January 11th.
Another way to look at it is that EDD is 40 weeks after the first day of your last period.
If the date of conception is known with precision, such as in vitro fertilization or fertility tracking where the date of ovulation is known, EDD is calculated by adding 266 days to the date of conception (or subtracting 7 days and subtracting 9 days). month). This improves EDD accuracy by not assuming her day 14 ovulation based on the first day of her last menstrual period.
In 1744, a Dutch professor named Hermann Boorhave explained how to calculate an estimated date. Based on data from 100 pregnant women, Boerhaave calculated the expected date of delivery by adding 7 days to the last period, then 9 months to him (Baskett & Nagele, 2000). .
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In 1812, a German professor named Karl Negele quoted Professor Boerhave and added some of his ideas. (This is where the Negele rule gets its name!) However, Negele, like Boorhave, does not say when the count should start, i.e. from the beginning of the last period, or from the last day of the last period. did not.
The text he can interpret in two ways. On the first day of the last period he adds seven days, or on the last day of the last period he adds seven days.
As the 1800s progressed, different physicians interpreted Negele’s rule in different ways. Most added 7 days
However, in the 1900s, for unknown reasons, American textbooks adopted the form of Negele’s rule adding his 7 days.
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And to this day, nearly all physicians use some form of Negele’s law to
This is not based on any actual evidence, and perhaps he is not even what Naegele intended.
Physicians began using ultrasound in the 1970s, soon after ultrasound measurements replaced the last menstrual period (LMP) as the most reliable method of determining gestational age (Morken et al. 2014).
A large body of evidence indicates that an ultrasound performed early in pregnancy is so far more accurate than using her LMP during pregnancy. In his 2015 Cochrane review, the researchers combined the results of his 11 randomized clinical trials to compare early routine ultrasounds with policies that didn’t offer routine ultrasounds. (Whitworth et al. 2015).
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Researchers have found that those who have ever had an ultrasound early are less likely to conceive after term.
In other words, using LMP to estimate due dates is likely to be misclassified as “late” and receive unnecessary introductions.
In Finland he enrolled more than 17,000 pregnant women in a large observational study, researchers found that ultrasound at any time between 8 weeks and her 16 weeks was more accurate than her LMP. I found When ultrasound was used instead of ‘sure’ LMP (i.e. mothers were ‘sure’ on the date of their last menstrual period), the number of ‘late’ pregnancies decreased from 10.3% to 2.7% (Taipare). & Hiilesmaa, 2001).
There are several reasons why LMP is typically less accurate than ultrasound (Savitz et al., 2002; Jukic et al., 2013; ACOG, 2017). LMP is less accurate due to the following issues that can occur:
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In a 2013 study, researchers grouped ultrasound scans into her less than 7 weeks, 7–10 weeks, 11–14 weeks, 14–19 weeks, and 20–27 weeks (Khambalia et al., 2013). ).
The authors concluded that 11 to 14 weeks is the most accurate time to perform ultrasound to determine gestational age. Approximately 68% of deliveries were within ±11 days of the expected due date calculated by ultrasound at 11-14 weeks. It was more accurate than any other ultrasound scan and more accurate than LMP.
Ultrasound accuracy decreased significantly from about 20 weeks. Using dates between 20 and 27 weeks predicted by LMP or ultrasound resulted in higher preterm and late birth rates.
In the Listening to Mothers III study, one in four mothers (26%) reported that their caregiver changed their due date based on a late pregnancy ultrasound. In 66% of mothers her due date was changed to an earlier date and in 34% of mothers the due date was changed to a later date (Declercq et al., 2013).
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Third-trimester ultrasounds are less accurate than previous ultrasounds before pregnancy and her LMP. A late pregnancy ultrasound is less accurate because it measures your baby’s size and compares it to a “normal” baby. All babies in early pregnancy are the same size. However, if the baby is larger than average, it is considered “coming due” after the ultrasound and the due date is moved forward (incorrectly).
The converse is true for children who are smaller than average at term. Your due date may be delayed. This is dangerous if your baby is growth-restricted, as babies with growth-restriction have a higher risk of stillbirth later in pregnancy. Because of these issues with late pregnancy ultrasounds, the American College of Obstetricians and Gynecologists states that dates should be changed only in very rare circumstances (2017).
They stated that the due date should only be changed after a late pregnancy ultrasound if 1) it is the first ultrasound for a pregnant person and 2) it differs from the LMP-suggested due date by 21 days or more. (ACOG, 2017). ). .
In the United States and other Western countries, induction is common at or before the 40th week, so today it is possible to accurately determine the percentage of people who give birth naturally and the percentage who give birth before, on the day of, or after their due date. It is impossible to know
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Previously, researchers measured the average length of normal pregnancy by measuring the time from ovulation (or last menstrual period, or ultrasound) to the due date in a large group of pregnant women and calculating the average. was doing. However, this method is imprecise and does not give accurate results.
This method doesn’t work because many are triggered when she reaches 39, 40, 41, or 42 weeks.
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