Biparietal diameter for first-trimester pregnancy dating: multicenter cohort study.

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology Pub Date : 2025-04-03 DOI:10.1002/uog.29216

C de Paco Matallana, V Rolle, A M Fidalgo, J Sánchez-Romero, J C Jani, P Chaveeva, J L Delgado, B Santacruz, K H Nicolaides, M M Gil

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引用次数: 0

Abstract

Objective: To evaluate the accuracy of fetal biparietal diameter (BPD) measurement in comparison with crown-rump length (CRL) measurement for pregnancy dating at 11-13 weeks' gestation.

Methods: This was a retrospective multicenter cohort study performed in five maternity units in Spain, the UK, Belgium and Bulgaria between January 2011 and December 2019. We included all women who attended a routine ultrasound examination at 11 + 0 to 13 + 6 weeks who had a singleton pregnancy with a viable non-malformed fetus/neonate and ultrasound-derived measurements for both CRL and BPD, along with a comprehensive record of pregnancy outcomes. We developed a formula for pregnancy dating based on BPD using data from pregnancies conceived via in-vitro fertilization (IVF) by applying a simple linear regression. We validated this formula both internally and externally and compared it with the most commonly used formulae (Robinson's CRL-based and Kustermann's BPD-based formulae) through utilization of the Euclidean distance, relative absolute error and mean squared error. We also examined the rate of induction of labor for post-term pregnancy based on dating using each of the formulae.

Results: A total of 49 492 women were included in the study, comprising 47 223 (95.4%) who conceived spontaneously and 2269 (4.6%) who conceived via IVF. In the internal validation performed using data from IVF pregnancies, our newly developed formula showed no significant difference when compared with the true gestational age calculated using conception date, with a mean difference of 0.0006 (95% CI, -0.09 to 0.09) days. In contrast, the mean difference of Kustermann's BPD-based formula was -0.31 (95% CI, -0.46 to -0.17) days and the mean difference of Robinson's CRL-based formula was -1.78 (95% CI, -1.88 to -1.68) days. In the external validation using data from spontaneously conceived pregnancies, with dating using Robinson's formula as the reference for 'true' gestational age, both our formula and Kustermann's formula resulted in underestimation of gestational age, with significant mean differences of -1.25 (95% CI, -1.28 to -1.22) days and -0.96 (95% CI, -0.98 to -0.93) days, respectively. The largest differences compared with Robinson's formula-based dating results were observed between 11 + 0 and 12 + 0 weeks. Dating the pregnancy using Robinson's formula led to 8.1% of pregnancies identified as requiring induction after 41 + 3 weeks, compared with 6.8% (P < 0.001) and 7.0% (P < 0.001) when applying our formula and Kustermann's formula, respectively.

Conclusion: Pregnancy dating based on ultrasound measurement of fetal BPD between 11 + 0 and 13 + 6 weeks' gestation is a reliable alternative to dating based on fetal CRL. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.

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早期妊娠期双顶叶直径测定：多中心队列研究。

目的：评价胎儿双顶叶直径（BPD）测量与冠臀长（CRL）测量在妊娠11-13周的准确性。方法：这是一项回顾性多中心队列研究，于2011年1月至2019年12月在西班牙、英国、比利时和保加利亚的五个产科单位进行。我们纳入了所有在11 + 0至13 + 6周期间接受常规超声检查的单胎妊娠、存活的无畸形胎儿/新生儿、超声衍生的CRL和BPD测量以及妊娠结局的综合记录的妇女。我们利用体外受精（IVF）怀孕的数据，通过简单的线性回归，开发了一个基于BPD的怀孕日期公式。我们对该公式进行了内部和外部验证，并利用欧几里得距离、相对绝对误差和均方误差与最常用的公式（Robinson’s CRL-based和Kustermann’s BPD-based公式）进行了比较。我们也检查了引产率为引产后妊娠基于日期使用每个配方。结果：共纳入49 492名妇女，其中47 223名（95.4%）自然受孕，2269名（4.6%）通过体外受精受孕。在使用IVF妊娠数据进行的内部验证中，我们新开发的配方与使用受孕日期计算的真实胎龄相比没有显着差异，平均差异为0.0006 （95% CI, -0.09至0.09）天。相比之下，Kustermann基于bpd公式的平均差值为-0.31 （95% CI, -0.46至-0.17）天，Robinson基于crl公式的平均差值为-1.78 （95% CI, -1.88至-1.68）天。在使用自然怀孕数据的外部验证中，使用Robinson公式作为“真实”胎龄的参考，我们的公式和Kustermann的公式都导致了胎龄的低估，平均差异分别为-1.25 （95% CI, -1.28至-1.22）天和-0.96 （95% CI, -0.98至-0.93）天。与罗宾逊基于公式的测年结果相比，最大的差异出现在11 + 0周和12 + 0周之间。在41 + 3周后使用罗宾逊公式确定妊娠日期的孕妇中，有8.1%确定需要引产，而这一比例为6.8% (P)结论：基于超声测量妊娠11 + 0至13 + 6周胎儿BPD的妊娠日期是基于胎儿CRL的可靠替代方法。©2025国际妇产科超声学会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ultrasound in Obstetrics & Gynecology 医学-妇产科学

CiteScore

12.30

自引率

14.10%

发文量

891

审稿时长

1 months

期刊介绍： Ultrasound in Obstetrics & Gynecology (UOG) is the official journal of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and is considered the foremost international peer-reviewed journal in the field. It publishes cutting-edge research that is highly relevant to clinical practice, which includes guidelines, expert commentaries, consensus statements, original articles, and systematic reviews. UOG is widely recognized and included in prominent abstract and indexing databases such as Index Medicus and Current Contents.