Current methods for estimating gestational age using clinical parameters can be inaccurate in prematurity. A simplified ultrasonographic system, based on cerebral sulcal development, for clinically determining fetal maturation in newborns was developed and studied in 148 newborns (92 appropriate-for-gestational-age, 54 small-for-gestational-age and 2 large-for-gestational age). This ultrasonographic sulcal method correlates better with the gestational age by dates than by the Dubowitz scoring system in the neonates less than 30 weeks' gestation. There are significant correlations between gestational age assessed by dates and by sonographic sulcal age in both appropriate-for-gestational-age (R = 0.91, P < 0.001) and small-for-gestational-age newborns (R = 0.92, P < 0.001). Maternal hypertension during pregnancy is a significant risk factor associated with accelerated fetal cerebral maturation in 12 neonates. Although overestimate of gestational age may occur in neonates born to mothers with hypertension, cranial ultrasonography is an accurate and convenient method of estimating gestational age in neonates.
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