The earlier age at delivery of multiple gestations is a reflection of the increased incidence of preterm labor and obstetric intervention for complications such as preeclampsia, abruptio placentae, fetal growth restriction, and increased risk for stillbirth that occurs as the number of fetuses increases [30-33]. Mongelli M, Wilcox M, Gardosi J.: Estimating the date of confinement: ultrasonographic biometery versus certain menstrual dates. The tendency for multiple gestations to be delivered earlier than singleton pregnancies should not be interpreted that multiples should be assigned an earlier estimated due date. Determining the Date of Conception Because the human egg is capable of fertilization for only 12 to 24 hours after ovulation the date of ovulation may be taken as being the date of conception. However, ultrasound determination of the date of ovulation has the same imprecision as does the ultrasound estimate of the gestational age and, therefore, a precise date of conception cannot usually be determined as with in vitro fertilization. The timing of the "fertile window" in the menstrual cycle: day specific estimates from a prospective study BMJ 2000; 321: 1259-1262. Effects on the probability of conception, survival of the pregnancy, and sex of the baby.
Human Chorionic Gonadotropin Pregnancy Test Human chorionic gonadotropin first becomes detectable in the mother's blood and urine between 6 and 14 days after fertilization (3 to 4 weeks gestational age) [11-13]. Other Methods For Estimating the Gestational Age Clinical Examination A pelvic examination supported by good menstrual records in the first trimester has been reported to be a reliable method for dating of pregnancy . Doppler Ultrasonography The fetal heart can be heard using Doppler ultrasound by 10 to 12 weeks in most patients . Savitz DA, Terry JW Jr, Dole N, Thorp JM Jr, Siega-Riz AM, Herring AH. The gestational age would, therefore, be at least 3 to 4 weeks at the time of a reliable h CG pregnancy test. Twins When a twin pregnancy is the result of in vitro fertilization determination of gestational age should be made from the date of embryo transfer. Clinical management guidelines for obstetricians-gynecologists. Number 55, September 2004 (replaces practice pattern number 6, October 1997).