• Alexis Salerno, Kevin Flanagan, Kenn Ghaffarian, Al HazmiAhmedADepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland., Michael D Witting, and Brian D Euerle.
• Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: alexis.salerno@som.umaryland.edu.
• J Emerg Med. 2022 Mar 1; 62 (3): 342-347.

BackgroundAn accurate estimation of fetal gestational age is essential for the management of pregnant patients who present to the emergency department (ED). Point-of-care-ultrasound (POCUS) is an integral part of emergency medicine training and includes measurement of fetal gestational age by the biparietal diameter (BPD) method.ObjectivesIn this study we performed a quantitative assessment of emergency physician (EP)-performed BPD estimate of gestational age to identify the percentage of studies performed in our department that had an estimated gestational age within 14 days of an adjusted radiological or obstetrical estimation.MethodsWe performed a chart review of our ED ultrasound database and electronic medical records for cases where a BPD measurement was performed by an EP. We recorded the ED gestational age estimate in days and the radiological or obstetrical estimate of gestational age in days. We then calculated the difference in days between the two examinations. We used a normal binomial approximation to calculate 95% confidence intervals. A secondary analysis looked at the quality of the images based on measurement placement and the view obtained.ResultsSeventy-four cases met eligibility criteria; of those, 67 (91%) had a gestational age estimation within 14 days of the adjusted radiological or obstetrical estimate (95% confidence interval 81-96%).ConclusionThis study shows that EP-performed BPD measurements for gestational age are quantitatively accurate, with 91% of estimates within 14 days of a standard radiological or obstetrical estimation.Copyright © 2021 Elsevier Ltd. All rights reserved.

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