A high index of suspicion and a low threshold for performing a β-hCG pregnancy test is recommended in all women presenting with clinical symptoms of ectopic pregnancy, regardless of the hysterectomy status. This could lead to earlier diagnosis and fewer complications.
Pregnancies complicated by preeclampsia or intrauterine growth retardation have an earlier and faster placental maturation than normal. This is demonstrated in a study of 1,096 obstetrical examinations of 473 non-diabetic mothers. It is recommended that a pregnancy demonstrating grade I maturational changes prior to 27 weeks, grade II changes prior to 32 weeks, or especially grade III changes prior to 34 weeks be followed clinically and ultrasonically for possible complications.
Measurement of crown-rump length (CRL) is widely accepted as the most accurate method of gestational dating. The statistical accuracy of growth-adjusted sonographic age (GASA) determinations has been demonstrated to be similar. Ninety-six patients were prospectively examined by use of serial ultrasonography, and findings were evaluated to correlate CRL with a single biparietal diameter (BPD) obtained between 20 and 24 weeks of gestation, with GASA, and with accurate maternal dates. Growth-adjusted sonographic age was shown to be not as accurate as CRL and no more accurate than a single BPD obtained between 20 and 24 weeks or reliable maternal dates.
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