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Management of Suboptimally Dated Pregnancies

Obstet Gynecol; ePub 2017 Mar; ACOG Comm Obset Pract

The American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice has issued a committee opinion on the management of suboptimally dated pregnancies. The document provides guidance for managing pregnancies in which the best clinical estimate of gestational age is suboptimal. ACOG includes the following recommendations and conclusions:

  • Pregnancies without an ultrasonographic examination confirming or revising the estimated due date before 22 0/7 weeks of gestation should be considered suboptimally dated.
  • The timing of indicated delivery in a woman with a suboptimally dated pregnancy should be based on the best clinical estimate of gestational age.
  • There is no role for elective delivery in a woman with a suboptimally dated pregnancy.
  • Amniocentesis for fetal lung maturity is not recommended as a routine component of decision making when considering delivery in a woman with a suboptimally dated pregnancy.
  • During the antenatal care of a woman with a suboptimally dated pregnancy, it is reasonable to consider an interval ultrasonographic assessment of fetal weight and gestational age 3–4 weeks after the initial ultrasonographic study.
  • Given concern that a full-term or late-term suboptimally dated pregnancy could actually be weeks further along than it is believed to be, initiation of antepartum fetal surveillance at 39–40 weeks of gestation may be considered.

Citation:

Management of suboptimally dated pregnancies. Committee Opinion No. 688. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;129:e29–32.