CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2020; 30(01): 27-31
DOI: 10.4103/ijri.IJRI_383_19
Obs and Gynecology

Discordant dating of pregnancy by LMP and ultrasound and its implications in perinatal statistics

Lalit K Sharma
Raj Sonography and X-Ray Clinic, Baiju Choraha, Nayapura
Jyoti Bindal
Department of Woman and Child Development, Guna, Madhya Pradesh
Vishal A Shrivastava
Department of Woman and Child Development, Guna, Madhya Pradesh
Mansi Sharma
Department of Obstetrics and Gynaecology, Columbia Asia and Sahyadri Hospital, Pune, Maharashtra
Rijo M Choorakuttil
National Coordinator for Samrakshan IRIA, AMMA Center for Diagnosis and Preventive Medicine
Praveen K Nirmalan
Chief Research Mentor, AMMA Education Research Foundation, Kochi, Kerala, India
› Author Affiliations
Financial support and sponsorship The NGO “Mansi Maa Beti Seva Samity” at Guna supported the purchase and distribution of medicines through the project.


Context: High perinatal mortality in India may be caused by inaccurate dating of pregnancy resulting from suboptimal uptake of antenatal care and ultrasound services during pregnancy. Aim: To determine the discrepancy in the last menstrual period (LMP) assigned expected date of delivery (EDD) and ultrasound assigned EDD in pregnant women in a rural district of central India. Methods: Data from an ongoing cross-sectional screening program providing fetal radiology imaging in Guna district of Madhya Pradesh from 2012–2019 was analyzed for recall of LMP and discordance between LMP and ultrasound assigned EDD. The discrepancy was present when EDD assigned by ultrasound differed by 3 or more days at gestational ages less than 8+6 weeks, 5–7 days at gestational ages 8+6 weeks till 14 weeks, and 7–10 days at gestational ages 14–20 weeks. Results: The program screened 14,701 pregnant women of which 4,683 (31.8+6%, 95% CI: 31.11, 32.61) could not recall LMP. EDD assigned by LMP and ultrasound matched in 7,035 (70.22%, 95% CI: 69.32, 71.12) of the remaining 10,018 pregnant women. EDD was overestimated by LMP for 26.06% (95% CI: 25.21, 26.93) women; these foetuses were at risk of being misclassified as a term fetus. In 2018, the project had no maternal deaths, infant mortality rate of 24.7, low birth weight rate of 9.69%, and 100% antenatal coverage. Conclusion: Accurate dating of pregnancy and systematic follow-up integrating radiology imaging and obstetrics care for appropriate risk-based management of pregnant women can significantly improve perinatal statistics of India.

Publication History

Received: 16 September 2019

Accepted: 16 January 2020

Publication Date:
19 July 2021 (online)

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