Crown-rump length

An ultrasound showing a fetus measured to have a crown-rump length of 1.67 cm, and estimated to have a gestational age of 8 weeks and 1 day

Crown-rump length (CRL) is the measurement of the length of human embryos and fetuses from the top of the head (crown) to the bottom of the buttocks (rump). It is typically determined from ultrasound imagery and can be used to estimate gestational age.

Measuring

Diagram showing crown-rump length by gestational age. The blue line is the mean and the green area delimits the 3rd versus the 97th percentile.[1]

The embryo and fetus float in the amniotic fluid inside the uterus of the mother usually in a curved posture resembling the letter C. The measurement can actually vary slightly if the fetus is temporarily stretching (straightening) its body. The measurement needs to be in the natural state with an unstretched body which is actually C shaped. The measurement of CRL is useful in determining the gestational age (menstrual age starting from the first day of the last menstrual period) and thus the expected date of delivery (EDD). Different babies do grow at different rates and thus the gestational age is an approximation. Recent evidence has indicated that CRL growth (and thus the approximation of gestational age) may be influenced by maternal factors such as age, smoking, and folic acid intake. Early in pregnancy it is accurate within +/- 4 days but later in pregnancy due to different growth rates, the accuracy is less. In that situation, other parameters can be used in addition to CRL. The length of the umbilical cord is approximately equal to the CRL throughout pregnancy.

Gestational age is not the same as fertilization age. It takes about 14 days from the first day of the last menstrual period for conception to take place and thus for the conceptus to form. The age from this point in time (conception) is called the fertilization age and is thus 2 weeks shorter than the gestational age. Thus a 6-week gestational age would be a 4-week fertilization age. Some authorities however casually interchange these terms and the reader is advised to be cautious. An average gestational period (duration of pregnancy from the first day of the last menstrual period up to delivery) is 280 days. On average, this is 9 months and 6 days.

Typical measurements

Gestational Age for CRL
Age CRL
6.1 Weeks: 0.4 cm
7.2 Weeks: 1.1 cm
8.0 Weeks: 1.9 cm
9.2 Weeks: 2.5 cm
9.6 Weeks: 2.9 cm
10.5 Weeks: 4.0 cm
12.2 Weeks: 5.5 cm
13.2 Weeks: 6.90 cm
14.0 Weeks: 8.0 cm

The following formula is an approximation that can be used up to 14 weeks of gestational age, with CRL in mm and gestational age in days:[2]

Gestational age = (CRL x 1.04)0.5 x 8.05 + 23.7

See also

References

  1. ↑ Ohuma EO, Papageorghiou AT, Villar J, Altman DG (2013). "Estimation of gestational age in early pregnancy from crown-rump length when gestational age range is truncated: the case study of the INTERGROWTH-21st Project". BMC Med Res Methodol. 13: 151. doi:10.1186/1471-2288-13-151. PMC 4029763Freely accessible. PMID 24314232.
    Crown rump length before a gestational age of 9 weeks is extrapolated by assuming a crown rump length of 0 at a gestational age of 2 weeks, corresponding to an embryonic age of 0 weeks. This extrapolated part is blurred because of uncertain values.
  2. ↑ Loughna, Pam; Chitty, Lyn; Evans, Tony; Chudleigh, Trish (2009). "Fetal Size and Dating: Charts Recommended for Clinical Obstetric Practice". Ultrasound. 17 (3): 160–166. doi:10.1179/174313409X448543. ISSN 1742-271X.

External links

This article is issued from Wikipedia - version of the 5/26/2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.