A complete audit cycle of ultrasound estimation of the date of delivery
DJR Hutchon, Consultant Obstetrician and Gynaecologist, Memorial Hospital, Darlington.
Estimation of the date of delivery (EDD) is a fundamental requirement for fetal assessment during antenatal care and is often the first thing a pregnant woman will want to know. Naegele's rule states that 280 days should be added to the first day of the last menstrual period to obtain the EDD 1, but this method has largely been overtaken by ultrasound2. Routine ultrasound dating is offered in the majority of western countries, commonly using the biparietal diameter in the second trimester to provide a gestation and from this an EDD is generated.
The accuracy of the ultrasound EDD should be regularly subjected to quality control and audited3. The audit cycle collects data to check whether accepted standards have been met. When the standard is not met, attempts are made to adjust management to improve the performance and the audit repeated to test for improved performance. We present an audit cycle of ultrasound dating in a district general hospital, completed with the adoption of a modified ultrasound dating formula.
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