It is appropriate to change the gestational age or EDD when the data used for screening are substantially above or below that determined by ultrasound. In case of a positive screen for trisomy 18, however, guidelines recommend against changing the gestational age or EDD (see Question 3.)
The earliest EDD calculated by ultrasound should be used for dating purposes.2 An ultrasound derived EDD is most accurate when determined in the first trimester. Accuracy decreases with advancing gestational age. For example, accuracy of an ultrasound EDD is ±7 days in the first trimester and ±10 days in the second trimester.
If a first trimester ultrasound EDD is available and the gestational age used for screening is within the EDD ±7 days, the gestational age should not be changed for screening purposes. If the gestational age used for screening is outside the ultrasound EDD range, it may be appropriate to change the gestational age used for screening.
If you want to change the EDD/gestational age used for a specific patient’s screening test, please contact your local Quest Diagnostics laboratory or call Quest Genomics Client Services at 866-GENE-INFO. If the revised gestational age is between 10.0 to 13.9 weeks gestation, we can calculate and report new risks. If the revised gestational age is <10.0 weeks, we cannot calculate new risks. Consider submitting a second specimen for screening, collected when the patient is between 10.0 to 13.9 weeks gestation. If the revised gestational age is >13.9 weeks gestation, we cannot calculate new risks, and a more accurate risk assessment cannot be provided. Consider submitting a second specimen for second trimester screening (ie, Penta Screen or Quad Screen) when the patient is between 15.0 to 22.9 weeks gestation (preferably 16 to 18 weeks).