Trisomy 21 associated transient neonatal myeloproliferation in the absence of Down's syndrome

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Abstract
AIMS To review the accuracy with which obstetric information on gestation is recorded in the neonatal records; and the reliability of the methods used for assessing gestational age after birth. METHODS Service information on all babies born in 1989, and research information on all babies of > 32 weeks gestation, and senior staff looked at 105 babies of < 30 weeks gestation. RESULTS The best techniques for estimating gestation immediately after birth were only half as accurate (95% CI ± 17 days) as estimates based on antenatal ultrasound at 15–19 weeks gestation. Assessments that relied on the tone, posture, and appearance of the baby at birth in those of < 32 weeks gestation were less reliable than assessments based on a retrospective review of when various reflex responses first appeared. They also tended to overestimate true gestation. Antenatal information of high quality was ignored, and arithmetic and transcription errors were introduced during the transfer of antenatal information into over 10% of postnatal records. CONCLUSIONS Current ultrasound techniques for “dating” pregnancy antenatally are better than any of the methods of postnatal assessment. Given the reliability of the antenatal information now available, it is regrettable that so many inaccuracies have been allowed to creep into the routine computation and recording of gestation at birth.