Normal Values in Pregnancy and Ultrasound Measurements





Henry L. Galan
Laura Goetzl




  • Invasive Cardiac Monitoring 1214



  • Noninvasive Cardiac Monitoring 1214



  • Arterial Blood Gas Values (Third Trimester) 1215



  • Pulmonary Function Tests 1215



  • Pulmonary Function Tests, Mean Values 1215



  • Peak Flows Stable Over Gestation 1215



  • Liver/Pancreatic Function Tests 1215



  • Electrolytes, Osmolality, and Renal Function 1216



  • Cholesterol and Lipids 1216



  • Hematologic Indices, Iron, and B 12 1216



  • Homocysteine, Vitamin, and Mineral Levels 1217



  • Calcium Metabolism 1217



  • Coagulation 1217



  • Inflammation and Immune Function 1218



  • Endocrine Tests 1218



  • Umbilical Cord Blood Gas Values and Hematologic Parameters 1218



  • Relationship Between Mean Amniotic Sac Diameter and Menstrual Age 1218



  • Crown-Rump Length (6–18 Weeks) 1219



  • Head Circumference 1219



  • Abdominal Circumference 1219



  • Femur Length 1220



  • Humerus Length 1220



  • Tibia Length 1220



  • Fibula Length 1220



  • Radius Length 1221



  • Ulna Length 1221



  • Foot Length 1221



  • Transcerebellar Diameter 1222



  • Amniotic Fluid Index 1222



  • Small Head Circumference Measurements 1222



  • Umbilical Artery Resistance Index and Systolic/Diastolic Ratio 1223



  • Middle Cerebral Artery Pulsatility Index 1223





INVASIVE CARDIAC MONITORING












































MEASURE VALUE (36-38 WEEKS) UNITS
Cardiac output * 6.2 ± 1.0 L/min
Systemic vascular resistance 1210 ± 266 Dyne/cm/sec −5
Heart rate 83 ± 10 Beats/min
Pulmonary vascular resistance 78 ± 22 Dyne/cm/sec −5
Colloid oncotic pressure 18.0 ± 1.5 mm Hg
Mean arterial pressure (MAP) 90.3 ± 5.8 mm Hg
Pulmonary capillary wedge pressure (PCWP) 7.5 ± 1.8 mm Hg
Central venous pressure (CVP) 3.6 ± 2.5 mm Hg
Left ventricular stroke work index 48 ± 6 g/mm −2

Data from Clark SL, Cotton DB, Lee W, et al. Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol. 1989;161:1439; Spatling L, Fallenstein F, Huch A, et al. The variability of cardiopulmonary adaptation to pregnancy at rest and during exercise. Br J Obstet Gynaecol. 1992;99(Suppl 8):1.

* Cardiac output increases during the first trimester of pregnancy but thereafter is essentially unchanged over the course of pregnancy; heart rate gradually rises 5 to 10 beats/min over the course of pregnancy.



NONINVASIVE CARDIAC MONITORING








































MEASURE 10-18 WEEKS 18-26 WEEKS 26-34 WEEKS 34-42 WEEKS
Cardiac output (L/min) 7.26 ± 1.56 7.60 ± 1.63 7.38 ± 1.63 6.37 ± 1.48
Stroke volume (mL) 85 ± 21 85 ± 21 82 ± 21 70 ± 14
Systemic vascular resistance (SVR) (dyne/cm/second −5 ) 966 ± 226 901 ± 224 932 ± 240 1118 ± 325
Heart rate (beats/min) 87 ± 14 90 ± 14 92 ± 14 92 ± 7
Mean arterial pressure (mm Hg) 87 ± 7 84 ± 7 84 ± 7 86 ± 7

Data from Van Oppen CA, Van Der Tweel I, Alsbach JGP, et al. A longitudinal study of maternal hemodynamics during normal pregnancy. Obstet Gynecol. 1996;88:40.


ARTERIAL BLOOD GAS VALUES (THIRD TRIMESTER)
























NORMAL ALTITUDE MODERATE ALTITUDE * (1388 M)
Arterial pH 7.40-7.48 7.44-7.48
Arterial P o 2 (mm Hg) 80-90 78.9-93.5
Arterial P co 2 (mm Hg) 26.9-32.5 23.9-29.3
Sodium bicarbonate (mEq/L) 19.9-24.1 16.7-20.5

Data from Hankins GD, Clark SL, Harvey CJ, et al. Third trimester arterial blood gas and acid base values in normal pregnancy at moderate altitude. Obstet Gynecol. 1996;88:347; and Eng M, Butler J, Bonica JJ. Respiratory function in pregnant obese women. Am J Obstet Gynecol. 1975;123:241.

* Provo, Utah.



PULMONARY FUNCTION TESTS






















8-11 WEEKS 20-23 WEEKS 28-31 WEEKS 36-40 WEEKS
Respiratory rate (breaths/min) 15 (14-20) 16 (15-18) 18 (15-20) 17 (16-18)
Tidal volume (mL) 640 (550-710) 650 (625-725) 650 (575-720) 700 (660-755)

Values expressed as median (25th to 75th percentiles).

Data from Spatling L, Fallenstein F, Huch A, et al. The variability of cardiopulmonary adaptation to pregnancy at rest and during exercise. Br J Obstet Gynaecol. 1992;99:1.


PULMONARY FUNCTION TESTS, MEAN VALUES





























FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER
Mean vital capacity (L) 3.8 3.9 4.1
Mean inspiratory capacity (L) 2.6 2.7 2.9
Mean expiratory reserve volume (L) 1.2 1.2 1.2
Mean residual volume (L) 1.2 1.1 1.0

Data from Gazioglu K, Kaltreider NL, Rosen M, Yu PN. Pulmonary function during pregnancy in normal women and in patients with cardiopulmonary disease. Thorax. 1920;25:445; and Puranik BM, Kaore SB, Kurhade GA, et al. A longitudinal study of pulmonary function tests during pregnancy. Indian J Physiol Pharmacol. 1994;38:129.


PEAK FLOWS STABLE OVER GESTATION
















PEAK FLOW (L/min)
Standing >320
Sitting >310
Supine >300

Data from Harirah HM, Donia SE, Nasrallah FK, et al. Effect of gestational age and position on peak expiratory flow rate: a longitudinal study. Obstet Gynecol. 2005;105:372.


LIVER/PANCREATIC FUNCTION TESTS


















































































FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
Total alkaline phosphatase (IU/L) 17-88 39-105 46-228 48-249
Gamma glutamyl transferase (IU/L) 2-37 2-43 4-41 5-79
Aspartate transaminase (AST, IU/L) 4-40 10-33 4-32 5-103
Alanine transaminase (ALT, IU/L) 1-32 2-34 2-32 5-115
Total bilirubin (mg/dL) 0.05-1.3 0.1-1.0 0.1-1.2 0.1-1.1
Unconjugated bilirubin (mg/dL) 0.1-0.5 0.1-0.4 0.1-0.5 0.2-0.6
Conjugated bilirubin (mg/dL) 0-0.1 0-0.1 0-0.1 —
Total bile acids (µM/L) 1.7-9.1 1.3-6.7 1.3-8.7 1.8-8.2
Elevated total bile acids (µM/L) >10 >10 >10 >10
Lactate dehydrogenase (U/L) 78-433 80-447 82-524 —
Amylase (IU/L) 11-97 14-92 14-97 10-82
Lipase (IU/L) 5-109 8-157 21-169 —

Data from Bacq Y, Zarka O, Brechot JF, et al. Liver function tests in normal pregnancy: a prospective study of 103 pregnant women and 103 matched controls. J Hepatol. 1996;23:1030; Karensenti D, Bacq Y, Brechot JF, Mariotte N, Vol S, Tichet J. Serum Amylase and lipase activities in normal pregnancy: a prospective case-control study. Am J Gastroenterol. 2001;96:697; Larsson A, Palm M, Hansson L-O, Axelsson O. Reference values for clinical chemistry tests during normal pregnancy. BJOG. 2008;115:874; Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Boca Raton, FL: CRC Press; 1993; van Buul EJA, Steegers EAP, Jongsma HW, et al. Haematological and biochemical profile of uncomplicated pregnancy in nulliparous women: a longitudinal study. Neth J Med. 1995;46:73; Girling JC, Dow E, Smith JH. Liver function tests in pre-eclampsia: importance of comparison with a reference range derived from normal pregnancy. BJOG. 1997;104;246; and Egan N. Reference standard for serum bile acids in pregnancy. BJOG. 2012;119;493.


ELECTROLYTES, OSMOLALITY, AND RENAL FUNCTION





























































































FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
Total osmolality (mOsm/kg) 267-280 269-289 273-283 271-289
Sodium (mEq/L) 131-139 129-142 127-143 124-141
Potassium (mEq/L) 3.2-4.9 3.3-4.9 3.3-5.2 3.4-5.5
Chloride (mEq/L) 99-108 97-111 97-112 95-111
Bicarbonate (meq/L) 18-26 18-26 17-27 17-25
Urea nitrogen (BUN, mg/dL) 5-14 4-13 3-13 4-15
Creatinine (mg/dL) 0.33-0.80 0.33-0.97 0.3-0.9 0.85-1.1
Serum albumin (g/dL) 3.2-4.7 2.7-4.2 2.3-4.2 2.4-3.9
Uric acid (mg/dL) 1.3-4.2 1.6-5.4 2.0-6.3 2.4-7.2
Urine volume (mL/24 hr) 750-2500 850-2,400 750-2700 550-3900
Creatinine clearance (mL/min) 69-188 55-168 40-192 52-208
Urine protein (mg/24 hr) 19-141 47-186 46-185 —
Urine protein/creatinine ratio (mg/mg); diagnosis of proteinuria <0.3 <0.3 <0.3 <0.3
Consider 24-hr collection when 0.15 to 0.29 Consider 24-hr collection when 0.15 to 0.29 Consider 24-hr collection when 0.15 to 0.29 Consider 24- hr collection when 0.15 to 0.29

Data from Ezimokhai M, Davison JM, Philips PR, Dunlop W. Non-postural serial changes in renal function during the third trimester of normal human pregnancy. Br J Obstet Gynaecol. 1981;88:465; Higby K, Suiter J, Phelps JY, et al. Normal values of urinary albumin and total protein excretion during pregnancy. Am J Obstet Gynecol. 1994;171:984; Larsson A, Palm M, Hansson L-O, Axelsson O. Reference values for clinical chemistry tests during normal pregnancy. BJOG. 2008;15:874; Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Boca Raton, FL: CRC Press; 1993; Milman N, Bergholt T, Byg KE, Eriksen L, Hvas AM. Reference intervals for haematologic variables during normal pregnancy and postpartum in 434 healthy Danish women. Eur J Haematol. 2007;79:39; van Buul EJ, Steegers EA, Jongsma HW, et al. Haematological and biochemical profile of uncomplicated pregnancy in nulliparous women: a longitudinal study. Neth J Med. 1995;46:73; And American College of Obstetricans and Gynecologists. Task Force on Hypertension in Pregnancy, 2013.


CHOLESTEROL AND LIPIDS








































FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
Total cholesterol (mg/dL) 117-229 136-299 161-349 198-341
HDL (mg/dL) 40-86 48-95 43-92 44-98
LDL (mg/dL) 39-153 41-184 42-224 86-227
VLDL (mg/dL) 10-18 13-23 15-36 25-51
Triglycerides (mg/dL) 11-209 20-293 65-464 103-440

HDL, high-density lipoprotein; LDL, low-density lipoprotein; TRI, trimester; VLDL, very-low-density lipoprotein.

Data from Belo L, Caslake M, Gaffney D, et al. Changes in LDL size and HDL concentration in normal and preeclamptic pregnancies. Atherosclerois. 2002;162:425; Desoye G, Schweditsch MO, Pfeiffer KP, Zechner R, Kostner GM. Correlation of hormones with lipid and lipoprotein levels during normal pregnancy and postpartum. J Clin Endocrinol Metab. 1987;64:704; Jimenez DM, Pocovi M, Ramon-Cajal J, Romero MA, Martinez H, Grande H. Longitudinal study of plasma lipids and lipoprotein cholesterol in normal pregnancy and puerperium. Gynecol Obstet Invest. 1988;25:158; Lain KY, Markovic N, Ness RB, Roberts JM. Effect of smoking on uric acid and other metabolic markers throughout normal pregnancy. J Clin Endocrinol Metab. 2005;90:5743; Lockitch G. Handbook of diagnostic biochemistry and hematology in normal pregnancy. Boca Raton, FL: CRC Press; 1993.


HEMATOLOGIC INDICES, IRON, AND B 12






















































































































FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
White blood cells (10 3 /mm 3 ) 3.9-13.8 4.5-14.8 5.3-16.9 4.2-22.2
Neutrophils (10 3 /mm 3 ) 2.2-8.8 2.9-10.1 3.8-13.1 4.8-12.9
Lymphocytes (10 3 /mm 3 ) 0.4-3.5 0.7-3.9 0.7-3.6 0.9-2.5
Monocytes (10 3 /mm 3 ) 0-1.1 0-1.1 0-1.4 0-0.8
Eosinophils (10 3 /mm 3 ) 0-0.6 0-0.6 0-0.6 —
Basophils (10 3 /mm 3 ) 0-0.1 0-0.1 0-0.1 —
Platelet count (10 9 /L) 149-433 135-391 121-429 121-397
Hemoglobin (g/dL) 11.0-14.3 10.5-13.7 11.0-13.8 11.0-14.6
Hematocrit (%) 33-41 32-38 33-40 33-42
Mean cell volume (fL) 81-96 82-97 81-99 82-100
Mean corpuscular hemoglobin (pg) 27-33 — 28-33 28-34
Free erythrocyte protoporphyrin (µg/g) <3 <3 <3 <3
Ferritin (serum, ng/mL) 10-123 10-101 10-48 10-64
Total iron binding capacity (µg/dL) 246-400 216-400 354-400 317-400
Iron (µg/dL) 40-215 40-220 40-193 40-193
Folate (serum, ng/mL) 2.3-39.3 2.6-15 1.6-40.2 1.7-19.3
Transferrin saturation (%) >16 >16 >16 >16
B 12 (pg/mL) 118-438 130-656 99-526 —

Data from American College of Obstetricians and Gynecologists. Anemia in Pregnancy. ACOG Practice Bulletin No. 95. Obstet Gynecol. 112:201, 2008; Balloch AJ, Cauchi MN. Reference ranges in haematology parameters in pregnancy derived from patient populations. Clin Lab Haemetol. 1993;15:7; Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Boca Raton, FL: CRC Press; 1993; Malkasian GD, Tauxe WN, Hagedom AB. Total iron binding capacity in normal pregnancy. J Nuclear Med. 1964;5:243; Milman N, Agger OA, Nielsen OJ. Iron supplementation during pregnancy. Effect on iron status markers, serum erythropoietin and human placental lactogen. A placebo controlled study in 207 Danish women. Dan Med Bull. 1991;38:471; Milman N, Bergholt T, Byg KE, Eriksen L, Hvas AM. Reference intervals for haematologic variables during normal pregnancy and postpartum in 434 healthy Danish women. Eur J Haematol. 2007;79:39; Romslo I, Haram K, Sagen N, Augensen K. Iron requirements in normal pregnancy as assessed by serum ferritin, serum transferring saturation and erythrocyte protoporphryin determinations. Br J Obstet Gynaecol. 1983;90:101; Tamura T, Goldenberg RL, Freeberg LE, Cliver SP, Cutter GR, Hoffman HJ. Maternal serum folate and zinc concentrations and their relationship to pregnancy outcome. Am J Clin Nutr. 1992;56:365; van Buul EJ, Steegers EA, Jongsma HW, et al. Haematological and biochemical profile of uncomplicated pregnancy in nulliparous women; a longitudinal study. Neth J Med. 1995;46:73; Walker MC, Smith GN, Perkins SL, Keely EJ, Garner PR. Changes in homocysteine levels during normal pregnancy. Am J Obstet Gynecol. 1999;180:660.


HOMOCYSTEINE, VITAMIN, AND MINERAL LEVELS














































FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
Homocysteine (µmol/L) 4.1-7.7 3.3-11.0 3.9-11.1 4.7-12.8
Homocysteine (µmol/L), on folate 5.0-7.6 2.9-5.5 3.1-5.8 —
Vitamin D 25(OH)D (ng/mL) >30 >30 >30 >30
Copper (µg/dL) 69-241 117-253 127-274 163-283
Selenium (µg/L) 98-160 85-164 84-162 84-144
Zinc (µg/dL) 51-101 43-93 41-88 39-71

Data from Izquierdo Alvarez S, Castañón SG, Ruata ML, et al. Updating of normal levels of copper, zinc and selenium in serum of pregnant women. J Trace Elem Med Biol. 2007;21:49; Ardawi MS, Nasrat HA, BA’Aqueel HS: Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study. Eur J Endocrinol. 1997;137:402; Dawson-Hughes B, Heany RP, Holick MF, et al. Estimates of optimal vitamin D status. Osteopor Int. 2005;16:713; Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Boca Raton, FL: CRC Press; 1993; Milman N, Bergholt T, Byg KE, Eriksen L, Hvas AM. Reference intervals for haematologic variables during normal pregnancy and postpartum in 434 healthy Danish women. Eur J Haematol. 2007; 79:39; Mimouni F, Tsang RC, Hertzberg VS, Neumann V, Ellis K. Parathyroid hormone and calcitor: changes in normal and insulin dependent diabetic pregnancies. Obstet Gynecol. 1989;74:49; Murphy MM, Scott JM, McPartlin JM, Fernandez-Ballart JD: The pregnancy-related decrease in fasting plasma homocysteine is not explained by folic acid supplementation, hemodilution, or a decrease in albumin in a longitudinal study. Am J Clin Nutr. 2002;76:614; Qvist I, Abdulla M, Jagerstad M, Svensson S. Iron, zinc and folate status during pregnancy and two months after delivery. Acta Obstet Gynecol Scand. 1986;65:15; Walker MC, Smith GN, Perkins SL, Keely EJ, Garner PR. Changes in homocysteine levels during normal pregnancy. Am J Obstet Gynecol. 1999;180:660.


CALCIUM METABOLISM




























FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
Total calcium (mg/dL) 8.5-10.6 7.8-9.4 7.8-9.7 8.1-9.8
Ionized calcium (mg/dL) 4.4-5.3 4.2-5.2 4.4-5.5 4.2-5.4
Parathyroid hormone (pg/mL) 7-15 5-25 5-26 10-17

Data from Ardawi MSM, Nasrat HAN, BA’Aqueel HS. Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study. Eur J Endocrinol. 1997;137:402; Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Boca Raton, FL: CRC Press; 1993; Mimouni F, Tsang RC, Hertzberg VS, Neumann V, Ellis K. Parathyroid hormone and calcitrol changes in normal and insulin dependent diabetic pregnancies. Obstet Gynecol. 1989;74:49; Pitkin RM, Reynolds WA, Williams GA, Hargis GK. Calcium metabolism in normal pregnancy: a longitudinal study. Am J Obstet Gynecol. 1979; 133:781; Seki K, Makimura N, Mitsui C, et al. Calcium-regulating hormones and osteocalcin levels during pregnancy: a longitudinal study. Am J Obstet Gynecol. 1991;164:1248.


COAGULATION






















































































































FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
Prothrombin time (sec) 8.9-12.2 8.6-13.4 8.3-12.9 7.9-12.7
International normalized ratio 0.89-1.05 0.85-0.97 0.81-0.95 0.80-0.94
Partial thromboplastin time (sec) 24.3-38.9 24.2-38.1 23.9-35.0 23.0-34.9
Fibrinogen (mg/dL) 278-676 258-612 276-857 444-670
D-dimer (µg/mL) 0.04-0.50 0.05-2.21 0.16-2.8 —
Antithrombin III (%) 89-112 88-112 81-135 82-138
Antithrombin III deficiency diagnostic criteria <60% <60% <60% <60%
Protein C, FA (%) 78-121 83-132 73-125 67-120
Protein-C deficiency diagnostic criteria <60% FA <60% FA <60% FA <60% FA
Protein S, total (%) 39-105 27-101 33-101 —
Protein S, free (%) 34-133 19-113 20-69 37-70
Protein S, FA (%) 57-95 42-68 16-42 —
Protein-S deficiency diagnostic criteria, FA% NA <30% <24% <24%
Factor II (%) 70-224 73-214 74-179 68-194
Factor V (%) 46-188 66-185 34-195 39-184
Factor VII (%) 60-206 80-280 84-312 87-336
Factor X (%) 62-169 74-177 78-194 72-208
Von Willebrand factor (%) — — 121-258 132-260

FA, functional activity.

Data from Cerneca F, Ricci G, Simeone R, et al. Coagulation and fibrinolysis changes in normal pregnancy. Increased levels of procoagulants and reduced levels of inhibitors during pregnancy induce a hypercoagulable state, combined with a reactive fibrinolysis. Eur J Obstet Gynecol Reprod Biol. 1997;73:31; Choi JW, Pai SH. Tissue plasminogen activator levels change with plasma fibrinogen concentrations during pregnancy. Ann Hematol. 1997;81:611; Faught W, Garner P, Jones G, Ivey B. Changes in protein C and protein S levels in normal pregnancy. Am J Obstet Gynecol. 1995;172:147; Francalanci I, Comeglio P, Liotta AA, Cellai AP, Fedi S, Parretti E. D-dimer concentrations during normal pregnancy, as measured by ELISA. Thromb Res. 1995;78:399; Lefkowitz JB, Clarke SH, Barbour LA. Comparison of protein S functional and antigenic assays in normal pregnancy. Am J Obstet Gynecol. 1996;175:657; Lockitch G. Handbook of diagnostic biochemistry and hematology in normal pregnancy. Boca Raton, FL: CRC Press; 1993; Morse M. Establishing a normal range for d-dimer levels through pregnancy to aid in the diagnosis of pulmonary embolism and deep vein thrombosis. J Thromb Haemost. 2004;2:1202; Stirling Y, Woolf L, North WR, Sebhatchian MJ, Meade TW. Haemostasis in normal pregnancy. Thromb Haemost. 1984;52:176; Wickstrom K, Edelstam G, Lowbeer CH, Hansson LO, Siegbahn A. Reference intervals for plasma levels of fibroenectin, von Willebrand factor, free protein S and antithrombin during third trimester pregnancy. Scand J Clin Lab Invest. 2004;64:31; Inherited thrombophilias in pregnancy. Practice Bulletin No. 138 American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013;122:706-717.


INFLAMMATION AND IMMUNE FUNCTION




















































FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
C-reactive protein (mg/L) 0.52-15.5 0.78-16.9 0.44-19.7 —
C3 complement (mg/dL) 44-116 51-119 60-126 64-131
C4 complement (mg/dL) 9-45 10-42 11-43 16-44
Erythrocyte sedimentation rate (mm/h) 4-57 7-83 12-90.5 —
Immunoglobulin A (mg/dL) 21-317 23-343 12-364 14-338
Immunoglobulin G (mg/dL) 838-1410 654-1330 481-1273 554-1162
Immunoglobulin M (mg/dL) 10-309 20-306 0-361 0-320

Data from Saarelainen H, Valtonen P, Punnonen K, et al. Flow mediated vasoldilation and circulating concentrations of high sensitive C-reactive protein, interleukin-6 and tumor necrosis factor-alpha in normal pregnancy—The Cardiovascular Risk in Young Finns Study. Clin Physiol Funct Imaging. 2009;29:347; Van den Brock NR, Letsky EA. Pregnancy and the erythrocyte sedimentation rate. BJOG. 2001;108:1164; Lockitch G. Handbook of diagnostic biochemistry and hematology in normal pregnancy. Boca Raton, FL: CRC Press; 1993.


ENDOCRINE TESTS




















































FIRST TRIMESTER SECOND TRIMESTER THIRD TRIMESTER TERM
Cortisol (µg/dL) 7-23 6-51 12-60 21-64
Aldosterone (ng/dL) 6-104 9-104 15-101 —
Thyroid-stimulating hormone (µIU/mL) 0.1-4.4 0.4-5.0 0.23-4.4 0.0-5.3
Thyroxine, free (ng/dL) 0.7-1.58 0.4-1.4 0.3-1.3 0.3-1.3
Thyroxine, total (µg/dL) 3.6-9.0 4.0-8.9 3.5-8.6 3.9-8.3
Triiodothyronine, free (pg/mL) 2.3-4.4 2.2-4.2 2.1-3.7 2.1-3.5
Triiodothyronine, total (ng/dL) 71-175 84-195 97-182 84-214

Data from Goland R, Jozak S, Conwell I. Placental corticotropin-releasing hormone and the hypercortisolism of pregnancy. Am J Obstet Gynecol. 1994;171:1287; Larsson A, Palm M, Hansson L-O, Axelsson O. Reference values for clinical chemistry tests during normal pregnancy. BJOG. 2008;15:874; Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Boca Raton, FL: CRC Press; 1993; Mandel SJ, Spencer CA, Hollowell JG. Are detection and treatment of thyroid insufficiency in pregnancy feasible? Thyroid. 2005;15:44; Price A, Obel O, Cresswell J, et al. Comparison of thyroid function in pregnant and non-pregnant Asian and western Caucasian women. Clin Chim Acta. 2001;308:91; Bliddal S, Feldt-Rasmussen U, Boas M et al. Gestational-age-specific references ranges from different laboratories misclassifies pregnant women’s thyroid status; comparison of two longitudinal prospective cohort studies. Eur J Endocrinol. 2013;170;329.


UMBILICAL CORD BLOOD GAS VALUES AND HEMATOLOGIC PARAMETERS *




















































ARTERY VEIN
pH 7.06-7.36 7.14-7.45
P co 2 (mm Hg) 27.8-68.3 24.0-56.3
P o 2 (mm Hg) 9.8-41.2 12.3-45.0
Base deficit (mmol/L) 0.5-15.3 0.7-12.6
White blood cell count (10 9 /L) 11.1-16.2
Red blood cell count (10 12 /L) 4.13-4.62
Hemoglobin (g/dL) 15.3-17.2
Hematocrit (%) 45.2-50.9
Mean corpuscular volume (fL) 107.4-113.3
Platelet count (10 9 /L) 237-321
Reticulocyte count (10 9 /L) 145.8-192.6

Data from Eskes TK, Jongsma HW, Houx PC. Percentiles for gas values in human umbilical cord blood. Eur J Obstet Gynecol Reprod Biol. 1983;14:341; Mercelina-Roumans P, Breukers R, Ubachs, J, Van Wersch J. Hematological variables in cord blood of neonates of smoking and non-smoking mothers. J Clin Epidemiol. 1996;49:449.

* Ranges represent 25th to 75th percentiles.



RELATIONSHIP BETWEEN MEAN AMNIOTIC SAC DIAMETER AND MENSTRUAL AGE




































































































MEAN SAC DIAMETER PREDICTED AGE (DAYS) 95% CI
2 34.9 34.3-35.5
3 35.8 35.2-36.3
4 36.6 36.1-37.2
5 37.5 37.0-38.0
6 38.4 37.9-38.9
7 39.3 38.9-39.7
8 40.2 39.8-40.6
9 41.1 40.7-41.4
10 41.9 41.6-42.3
11 42.8 42.5-43.2
12 43.7 43.4-44.0
13 44.6 44.3-44.9
14 45.5 45.2-45.8
15 46.3 46.0-46.6
16 47.2 46.9-47.5
17 48.1 47.8-48.4
18 49 48.6-49.4
19 49.9 49.5-50.3
20 50.8 50.3-51.2
21 51.6 51.2-52.1
22 52.5 52.0-53.0
23 53.4 52.9-53.9
24 54.3 53.7-54.8

CI, confidence interval.

From Daya S, Wood S, Ward S, et al. Early pregnancy assessment with tranSvaginal ultrasound scanning. Can Med Assoc J. 1991;144:444.


CROWN-RUMP LENGTH (6-18 Weeks)





























































































































































































































CROWN-RUMP LENGTH (MM) MENSTRUAL AGE (WEEKS) CROWN-RUMP LENGTH (MM) MENSTRUAL AGE (WEEKS) CROWN-RUMP LENGTH (MM) MENSTRUAL AGE (WEEKS)
1 1 30 10.0 61 12.6
2 2 32 10.1 62 12.6
3 5.9 33 10.2 63 12.7
4 6.1 34 10.3 64 12.8
5 6.2 35 10.4 65 12.8
6 6.4 36 10.5 66 12.9
7 6.6 37 10.6 67 13.0
8 6.7 38 10.7 68 13.1
9 6.9 39 10.8 69 13.1
10 7.1 40 10.9 70 13.2
11 7.2 41 11.0 71 13.3
12 7.4 42 11.1 72 13.4
13 7.5 43 11.2 73 13.4
14 7.7 44 11.2 74 13.5
15 7.9 45 11.3 75 13.6
16 8.0 46 11.4 76 13.7
17 8.1 47 11.5 77 13.7
18 8.3 48 11.6 78 13.8
19 8.4 49 11.7 79 13.9
20 8.6 50 11.7 80 14.0
21 8.7 51 11.8 81 14.1
22 8.9 52 11.9 82 14.2
23 9.0 53 12.0 83 14.2
24 9.1 54 12.0 84 14.3
25 9.2 55 12.1 85 14.4
26 9.4 56 12.2 86 14.5
27 9.5 57 12.3 87 14.6
28 9.6 58 12.3 88 14.7
29 9.7 59 12.4 89 14.8
30 9.9 60 12.5 90 14.9

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Mar 31, 2019 | Posted by in OBSTETRICS | Comments Off on Normal Values in Pregnancy and Ultrasound Measurements

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