PubMed · 7736365
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P C Tessier. 1995-04-15. Forceps use: a gender issue?. https://pubmed.ncbi.nlm.nih.gov/7736365/
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The use of routine obstetric ultrasound has been shown to accurately diagnose fetal gastrointestinal anomalies, both during and after the midtrimester. These are among the most accurately diagnosed of all anomalies, comprising 5-7% of all fetal anomalies. From a review of the literature it is clear that the use of routine ultrasound allows: (1) the detection of multiple anomalies that are often present and affect outcome significantly, (2) preparation for delivery at a tertiary center where neonatal surgical experience will allow optimal outcome, and (3) decisions about mode and timing of delivery in cases where this is important, i.e., cases of omphalocele and gastroschisis.
It has been claimed that the expected day of delivery (EDD) determined on the basis of an ultrasound scan is more accurate than using a calendar method. The aim of this paper is to assess the evidence in support of this claim. A critical review of the methodologically best research revealed that among women with regular cycles and know first day of the last menstrual period, Naegele's rule predicted the EDD to be 3.3 days too early, on average, whereas prediction based on ultrasound scans was 2.0 days too late. The standard deviations of the two distributions were the same. After correction for the systematic biases, the two methods of prediction were thus equally precise. It is concluded that the EDD should be calculated by adding 283 days to the date of the last period rather than by adding 280 days. For women with regular cycles and known first day of the last menstrual period, ultrasound dating does not lead to a more precise prediction.
OBJECTIVE: To evaluate the usefulness of serum estradiol levels obtained on the fourth day of gonadotropin stimulation in predicting the likelihood of pregnancy during controlled ovarian hyperstimulation (COH) using luteal phase leuprolide acetate (LA). DESIGN: A 4-year retrospective analysis of day 4 estradiol levels and subsequent clinical pregnancy and delivery rates. SETTING: A university hospital tertiary referral center. PATIENT(S): Couples undergoing IVF treatment. MAIN OUTCOME MEASURE(S): Primary outcome measures included clinical pregnancy and delivery rates. Secondary outcome measures included the number of oocytes retrieved and the number of embryos available for transfer per COH cycle. RESULT(S): The clinical pregnancy and delivery rates for cycles with day 4 estradiol levels of >75 pg/mL were 42.3% (30/71) and 32.4% (23/71), respectively. These rates differed significantly from those for cycles with day 4 estradiol levels of < or = 75 pg/mL, which were only 9.1% (4/44) and 6.8% (3/44), respectively. The number of oocytes retrieved and the number of embryos available for transfer for cycles with day 4 estradiol levels of >75 pg/mL also differed significantly from those for cycles with day 4 estradiol levels of < or = 75 pg/mL (11.4 and 7.8 versus 6.8 and 4.3, respectively). CONCLUSION(S): Estradiol levels obtained on the fourth day of gonadotropin therapy are highly predictive of successful ovulation induction and pregnancy outcome in cycles using luteal phase LA.