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BJOG. 2013 Sep;120 Suppl 2:38-41, v. doi: 10.1111/1471-0528.12056. Epub 2013 May 17.

Standardisation of crown-rump length measurement.

Collaborators (243)

Katz M, Bhan MK, Garza C, Zaidi S, Langer A, Rothwell PM, Weatherall D, Bhutta ZA, Villar J, Kennedy S, Altman DG, Barros FC, Bertino E, Burton F, Carvalho M, Cheikh Ismail L, Chumlea WC, Gravett MG, Jaffer YA, Lambert A, Lumbiganon P, Noble JA, Pang RY, Papageorghiou AT, Purwar M, Rivera J, Victora C, Villar J, Altman DG, Bhutta ZA, Cheikh Ismail L, Kennedy S, Lambert A, Noble JA, Papageorghiou AT, Villar J, Kennedy S, Cheikh Ismail L, Lambert A, Papageorghiou AT, Shorten M, Hoch L, Knight HE, Ohuma EO, Cosgrove C, Blakey I, Altman DG, Roseman F, Kunnawar N, Gu SH, Wang JH, Wu MH, Domingues M, Gilli P, Juodvirsiene L, Hoch L, Musee N, Al-Jabri H, Waller S, Cosgrove C, Muninzwa D, Ohuma EO, Yellappan D, Carter A, Reade D, Miller R, Papageorghiou AT, Salomon L, Leston A, Mitidieri A, Al-Aamri F, Paulsene W, Sande J, Al-Zadjali WK, Batiuk C, Bornemeier S, Carvalho M, Dighe M, Gaglioti P, Jacinta N, Jaiswal S, Noble JA, Oas K, Oberto M, Olearo E, Owende MG, Shah J, Sohoni S, Todros T, Venkataraman M, Vinayak S, Wang L, Wilson D, Wu QQ, Zaidi S, Zhang Y, Chamberlain P, Danelon D, Sarris I, Dhami J, Ioannou C, Knight CL, Napolitano R, Pace C, Mkrtychyan V, Cheikh Ismail L, Chumlea WC, Al-Habsi F, Bhutta ZA, Carter A, Alija M, Jimenez-Bustos JM, Kizidio J, Puglia F, Kunnawar N, Liu H, Lloyd S, Mota D, Ochieng R, Rossi C, Sanchez Luna M, Shen YJ, Knight HE, Rocco DA, Frederick IO, Bhutta ZA, Albernaz E, Batra M, Bhat BA, Bertino E, Di Nicola P, Giuliani F, Rovelli I, McCormick K, Ochieng R, Pang RY, Paul V, Rajan V, Wilkinson A, Varalda A, Eskenazi B, Corra LA, Dolk H, Golding J, Matijasevich A, de Wet T, Zhang JJ, Bradman A, Finkton D, Burnham O, Farhi F, Barros FC, Domingues M, Fonseca S, Leston A, Mitidieri A, Mota D, Sclowitz IK, da Silveira MF, Pang RY, He YP, Pan Y, Shen YJ, Wu MH, Wu QQ, Wang JH, Yuan Y, Zhang Y, Purwar M, Choudhary A, Choudhary S, Deshmukh S, Dongaonkar D, Ketkar M, Khedikar V, Kunnawar N, Mahorkar C, Mulik I, Saboo K, Shembekar C, Singh A, Taori V, Tayade K, Somani A, Bertino E, Di Nicola P, Frigerio M, Gilli G, Gilli P, Giolito M, Giuliani F, Oberto M, Occhi L, Rossi C, Rovelli I, Signorile F, Todros T, Carvalho M, Kizidio J, Ochieng R, Shah J, Stones W, Vinayak S, Musee N, Kisiang'ane C, Muninzwa D, Jaffer YA, Al-Abri J, Al-Abduwani J, Al-Habsi FM, Al-Lawatiya H, Al-Rashidiya B, Al-Zadjali WK, Juangco FR, Venkataraman M, Al-Jabri H, Yellappan D, Kennedy S, Cheikh Ismail L, Papageorghiou AT, Roseman F, Lambert A, Lloyd S, Napolitano R, Ioannou C, Sarris I, Gravett MG, Batiuk C, Batra M, Bornemeier S, Dighe M, Oas K, Paulsene W, Wilson D, Frederick IO, Andersen HF, Abbott SE, Carter AA, Algren H, Rocco DA, Sorensen TK, Enquobahrie D, Waller S.

Author information

  • 1Nuffield Department of Obstetrics & Gynaecology, Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.

Abstract

Correct estimation of gestational age is essential for any study of ultrasound biometry and for everyday clinical practice. However, inconsistency in pregnancy dating may occur through differences in measurement methods or errors during measurement. In the INTERGROWTH-21(st) Project, pregnancies are dated by the last menstrual period, provided that it is certain and associated with a regular menstrual cycle, and the gestational age by dates concurs with a first-trimester ultrasound crown-rump length (CRL) estimation. Hence, there was a need to standardise CRL measurement methodology across the study sites in this international, multicentre project to avoid systematic differences in dating. To achieve uniformity we undertook the following steps: the ultrasound technique was standardised by disseminating an illustrated, operating manual describing CRL plane landmarks and calliper application, and posters describing the correct acquisition technique were disseminated for quick reference. To ensure that all ultrasonographers understood the methodology, they forwarded a log-book to the INTERGROWTH-21(st) Ultrasound Coordinating Unit, containing the answers to a written test on the manual material and five images of a correctly acquired CRL. Interpretation of CRL was also standardised by ensuring that the same CRL regression formula was used across all study sites. These methods should minimise potential systematic errors in dating associated with pooling data from different health institutions, and represent a model for standardising CRL measurement in future studies.

© 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

KEYWORDS:

Crown-rump length; dating; gestation; growth; pregnancy; ultrasound

PMID:
23678951
[PubMed - indexed for MEDLINE]
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