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Luteinizing Hormone Surge More Accurately Correlates With Ultrasound Dating of Early Pregnancy Compared to the Last Menstrual Period
Author(s) -
Morong James J.,
McQueen Dana B.,
Stephenson Mary D.
Publication year - 2021
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.15515
Subject(s) - medicine , concordance , pregnancy , luteinizing hormone , gestational age , gynecology , obstetrics , ultrasound , crown rump length , gestation , hormone , genetics , radiology , biology , first trimester
Objectives To compare the use of the luteinizing hormone (LH) surge versus the last menstrual period (LMP) for the accuracy of pregnancy dating in fertile women with a diagnosis of recurrent early pregnancy loss (REPL). Methods This was an observational cohort study using prospectively collected data at 2 academic REPL programs between 2005 and 2018. Women with a history of REPL and at least 1 subsequent live birth after the evaluation were included. All patients conceived by intercourse timed to the LH surge. Transvaginal ultrasound was examinations were performed 2 weeks after missed menses. The gestational age (GA) was calculated by the LH surge (GA LH ), LMP (GA LMP ), and first crown‐rump length (CRL) that measured 5 mm or greater (GA CRL ). A secondary analysis compared GA based on the first measurable CRL of less than 5 mm versus GA based on the first CRL of 5 mm or greater. The GA LH and GA LMP were compared to determine which measure showed greater concordance with the CRL. The mean absolute difference in days between the GA CRL versus GA LH and GA CRL versus GA LMP was determined. Results A total of 115 women with 118 subsequent pregnancies resulting in live birth were included, with a mean age at delivery of 35.5 years and a mean of 3.6 prior pregnancy losses. The GA LH showed a stronger correlation with the CRL (0.77) than the GA LMP (0.63; P = .002). The GA LH was more similar to the GA CRL than the GA LMP , with a mean absolute difference of 2.0 versus 3.1 days ( P < .0001). Conclusions When known, the LH surge appears to be more accurate than the LMP and should be used preferentially for dating of early pregnancy.