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{{Header}}
{{Header}}
==Introduction==
==Introduction==
[[File:Stage13 crown rump length.jpg|thumb|150px|alt=Crown-rump length|Crown-rump length Human embryo ([[Carnegie stage 13|stage 13]])]]
[[File:Stage13 crown rump length.jpg|thumb|alt=Crown-rump length|Crown-rump length measurement of a human embryo (Carnegie stage {{CS13}})]]
(CRL,  greatest length, GL) A measurement used in embryology to more accurately stage the early embryo, also historically called the "greatest length" (GL). Measured from the curvature at the top (crown) to the curvature at the bottom (rump) of the "C-shaped" early embryo.  
({{CRL}}) A measurement used in embryology to more accurately stage the early embryo, also historically called the "greatest length" (GL). Measured from the curvature at the top (crown) to the curvature at the bottom (rump) of the "C-shaped" early embryo. Historically, Mall (1918)<ref name=Mall1918>{{Ref-Mall1918}}</ref> and Streeter (1920<ref name=Streeter1920>{{Ref-Streeter1920}}</ref>, 1957<ref name=Streeter1957>{{Ref-Streeter1957}}</ref>) measured many human embryos to establish embryonic growth curves.




Used in clinical [[ultrasound]] as a measurement between the periods of 7 to 13 weeks as an accurate estimation of the gestational age.
Modern measurements in clinical medicine are based upon {{ultrasound}} as a measurement between the periods of 7 to 13 weeks as an accurate estimation of the {{GA}} gestational age.


{|
|-bgcolor="F5FFFA"
| '''Links:''' {{embryonic}} | [[Carnegie Stage Comparison]] | {{ultrasound}} | {{growth charts}} | [[Book_-_Contributions_to_Embryology|Carnegie Institution - Contributions to Embryology]] | [[Human Embryo Collections]]
|-
|
{| class="wikitable mw-collapsible mw-collapsed"
! [[Historic Embryology Papers|'''Historic Embryology''']] Crown-Rump Length &nbsp;
|-
| [[Paper - On The Age Of Human Embryos|1918 Age Of Human Embryos]] | [[Book - Contributions to Embryology Carnegie Institution No.55|1920 Sitting Height Human Embryos]] | [[Paper - Human Embryo Horizons 19-23|1957 Week 7-8 CRL]]
|}
|}
==Some Recent Findings==
{|
|-bgcolor="F5FAFF"
|
* '''21st and the World Health Organization Multicentre Growth Reference Study'''{{#pmid:29275821|PMID29275821}} "Three recently completed longitudinal cohort studies have developed intrauterine fetal growth charts, one in the United States and two international. This expert review compares and contrasts the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies, INTERGROWTH-21st and World Health Organization Multicentre Growth Reference Study conclusions in light of differences in aims, sampling frames, and analytical approaches. An area of controversy is whether a single growth reference is representative of growth, regardless of ethnic or country origin. The INTERGROWTH and World Health Organization Fetal studies used a similar approach as the World Health Organization Multicentre Growth Reference Study for infants and children, the aim of which was to create a single international reference for the best physiological growth for children aged 0-5 years." [[#INTERGROWTH|INTERGROWTH]]
|}
{| class="wikitable mw-collapsible mw-collapsed"
! More recent papers &nbsp;
|-
| [[File:Mark_Hill.jpg|90px|left]] {{Most_Recent_Refs}}
Search term: [http://www.ncbi.nlm.nih.gov/pubmed/?term=Crown-Rump+Length ''Crown-Rump Length'']
<pubmed limit=5>Crown-Rump%20Length</pubmed>
|}
==Ultrasound CRL==
Note that clinical {{GA}} gestational age is about 2 weeks more than the fertilisation age.
{{FA-GA-CRLCollapse Table}}
{{CRL-GA Collapse Table}}
{{Human fetal length-weight table}}


:'''Links:''' [[Embryonic_Development|Embryonic Development]] | [[Carnegie Stage Comparison]] | [[Book_-_Contributions_to_Embryology|Carnegie Institution - Contributions to Embryology]] | [[Human Embryo Collections]]  
:'''Links:''' [[:Template:CRL-GA Table|CRL-GA Table]] | [[:Template:FA-GA-CRLCollapse Table|FA-GA-CRL]]
==Embryo CRL==
==Historic Embryo CRL==
{|
{|
| [[File:Mall1918-fig01.jpg|400px]]
| [[File:Mall1918-fig01.jpg|400px]]
| [[File:Streeter1920chart1.jpg|400px]]
| [[File:Streeter1920chart1.jpg|400px]]
|-
|-
| Mall (1918)<ref>{{Ref-Mall1918}}</ref>
| Mall (1918)<ref name=Mall1918>{{Ref-Mall1918}}</ref>
| Streeter (1920) Graph of embryo CRL<ref>{{Ref-Streeter1920}}</ref>
| Streeter (1920) Graph of embryo CRL<ref name=Streeter1920>{{Ref-Streeter1920}}</ref>
|}
|}


===Embryo CRL 11 - 23===
This graph showing change in CRL during the {{embryonic}} period is based upon the [[Carnegie Collection]] embryos from a later 1957 paper by Streeter.<ref name=Streeter1957>{{Ref-Streeter1957}}</ref>
<br>
[[File:Streeter1957 fig01.jpg|600px]]
<br>
===Carnegie Stages===
{{Carnegie_stage_table_1}}
{|
|+ Carnegie Stages snd {{CRL}}
|-
! Carnegie Stage
! {{CRL}} (mm)
|-
| 7
| 0.4
|-
| 8
| 1.0 - 1.5
|-
| 9
| 1.5 - 2.5
|-
| 10
| 2 - 3.5
|-
| 11
| 2.5 - 4.5
|-
| 12
| 3 - 5
|-
| 13
| 4 - 6
|-
| 14
| 5 - 7
|-
| 15
| 7 - 9
|-
| 16
| 8 - 11
|-
| 17
| 11 - 14
|-
| 18
| 13 - 17
|-
| 19
| 16 - 18
|-
| 20
| 18 - 22
|-
| 21
| 22 - 24
|-
| 22
| 23 - 28
|-
| 23
| 27 - 31
|}
==Fetal CRL==
==Fetal CRL==
===Ultrasound===
{{Human fetal length-weight table}}
[[File:Keibel Mall 144.jpg|thumb|Human Embryo No. 131 90 mm CRL]]
[[File:Keibel Mall 144.jpg|thumb|Human Embryo No. 131 90 mm CRL]]
[[File:Fetal length change.jpg|500px]]
[[File:Fetal length change.jpg|500px]]


==Third Trimester CRL==
===Third Trimester CRL===


[[File:Third trimester Crown-Rump Length graph.jpg|500px]]
[[File:Third trimester Crown-Rump Length graph.jpg|500px]]
==Postnatal==
See associated Neural Exam movies - [[Neural Exam - Newborn head circumference|Measuring Newborn head circumference]]
===INTERGROWTH===
21st and the World Health Organization Multicentre Growth Reference Study{{#pmid:29275821|PMID29275821}}
* Three recently completed longitudinal cohort studies have developed intrauterine fetal growth charts
** one in the United States and two international.
* expert review compares and contrasts the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies, INTERGROWTH-21st and World Health Organization Multicentre Growth Reference Study conclusions
* area of controversy is whether a single growth reference is representative of growth, regardless of ethnic or country origin. * INTERGROWTH and World Health Organization Fetal studies used a similar approach as the World Health Organization Multicentre Growth Reference Study for infants and children, the aim of which was to create a single international reference for the best physiological growth for children aged 0-5 years.
* INTERGROWTH found differences in crown-rump length and head circumference among countries but interpreted the differences as not meaningful and presented a pooled standard.
* recognition of the fact that fetal size is commonly estimated from dimensions (head circumference, abdominal circumference, and femur length) in which there are known differences in children and adults of differing racial/ethnic groups.
* the percentiles for fetal dimensions and estimated fetal weight varied among the studies.
* 39 weeks -  the 50th percentile for estimated fetal weight
** Eunice Kennedy Shriver National Institute of Child Health and Human Development Study - 3502 g for whites, 3330 g for Hispanics, 3263 g for Asians, and 3256 for blacks
** INTERGROWTH - 3186 g
** World Health Organization Multicentre Growth Reference Study - 3403 g
:Links: [https://intergrowth21.tghn.org INTERGROWTH-21<sup>st</sup>]


==References==
==References==
Line 40: Line 169:




==External Links==
{{External Links}}
* [https://intergrowth21.tghn.org INTERGROWTH-21<sup>st</sup>]


{{Glossary}}
{{Glossary}}

Revision as of 09:57, 17 October 2018

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Introduction

Crown-rump length
Crown-rump length measurement of a human embryo (Carnegie stage 13)

(CRL) A measurement used in embryology to more accurately stage the early embryo, also historically called the "greatest length" (GL). Measured from the curvature at the top (crown) to the curvature at the bottom (rump) of the "C-shaped" early embryo. Historically, Mall (1918)[1] and Streeter (1920[2], 1957[3]) measured many human embryos to establish embryonic growth curves.


Modern measurements in clinical medicine are based upon ultrasound as a measurement between the periods of 7 to 13 weeks as an accurate estimation of the GA gestational age.

Links: embryonic | Carnegie Stage Comparison | ultrasound | growth charts | Carnegie Institution - Contributions to Embryology | Human Embryo Collections
Historic Embryology Crown-Rump Length  
1918 Age Of Human Embryos | 1920 Sitting Height Human Embryos | 1957 Week 7-8 CRL

Some Recent Findings

  • 21st and the World Health Organization Multicentre Growth Reference Study[4] "Three recently completed longitudinal cohort studies have developed intrauterine fetal growth charts, one in the United States and two international. This expert review compares and contrasts the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies, INTERGROWTH-21st and World Health Organization Multicentre Growth Reference Study conclusions in light of differences in aims, sampling frames, and analytical approaches. An area of controversy is whether a single growth reference is representative of growth, regardless of ethnic or country origin. The INTERGROWTH and World Health Organization Fetal studies used a similar approach as the World Health Organization Multicentre Growth Reference Study for infants and children, the aim of which was to create a single international reference for the best physiological growth for children aged 0-5 years." INTERGROWTH
More recent papers  
Mark Hill.jpg
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This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.

  • This search now requires a manual link as the original PubMed extension has been disabled.
  • The displayed list of references do not reflect any editorial selection of material based on content or relevance.
  • References also appear on this list based upon the date of the actual page viewing.


References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.

More? References | Discussion Page | Journal Searches | 2019 References | 2020 References

Search term: Crown-Rump Length

<pubmed limit=5>Crown-Rump%20Length</pubmed>

Ultrasound CRL

Note that clinical GA gestational age is about 2 weeks more than the fertilisation age.

Fertilization and Gestational Age - Crown-Rump Length (ultrasound
Fertilization Age
(days)
Gestational Age
GA (week.day)
Crown-Rump
Length (mm)
37 5.2 1
38 5.3 2
39 5.4 3
40 55 3
41 5.6 4
42    Week 4 6 4
43 6.1 5
44 6.2 6
45 6.3 7
46 6.4 8
47 6.5 9
48 6.6 10
49    Week 5 7 11
50 7.1 11
51 7.2 12
52 7.3 12
53 7.4 13
54 7.5 14
55 7.6 15
56    Week 6 8 17
57 8.1 18
58 8.2 19
59 8.3 20
60 8.4 21
61 8.5 22
62 8.6 22
63    Week 7 9 23
64 9.1 24
65 9.2 26
66 9.3 27
67 9.4 28
68 9.5 29
69 9.6 31
70    Week 8 10 34
71 10.1 36
72 10.2 37
73 10.3 38
74 10.4 39
75 10.5 39
76 10.6 40
77    Week 9 11 44
78 11.1 45
79 11.2 47
80 11.3 48
81 11.4 52
82 11.5 55
83 11.6 56
84    Week 10 12 57
85 12.1 58
86 12.2 60
87 12.3 61
88 12.4 63
89 12.5 64
90 12.6 65
91    Week 11 13 68
92 13.1 70
93 13.2 72
94 13.3 74
95 113.4 76
96 135 77
97 13.6 80
98    Week 12 14 81
99 14.1 84
100 14.2 85
101 14.3 86
102 14.4 87
Reference: Table data measured by ultrasound, adapted from Westerway (2015) PDF and[5]
Links: ultrasound | Fetal Development
Gestational Age and Crown-Rump Length (measured by ultrasound
Gestational Age
GA (week.day)
Crown-Rump
Length (CRL)
5.2 1
5.3 2
5.4 3
55 3
5.6 4
6 4
6.1 5
6.2 6
6.3 7
6.4 8
6.5 9
6.6 10
7 11
7.1 11
7.2 12
7.3 12
7.4 13
7.5 14
7.6 15
8 17
8.1 18
8.2 19
8.3 20
8.4 21
8.5 22
8.6 22
9 23
9.1 24
9.2 26
9.3 27
9.4 28
9.5 29
9.6 31
10 34
10.1 36
10.2 37
10.3 38
10.4 39
10.5 39
10.6 40
11 44
11.1 45
11.2 47
11.3 48
11.4 52
11.5 55
11.6 56
12 57
12.1 58
12.2 60
12.3 61
12.4 63
12.5 64
12.6 65
13 68
13.1 70
13.2 72
13.3 74
113.4 76
135 77
13.6 80
14 81
14.1 84
14.2 85
14.3 86
14.4 87
Reference

Table adapted from Westerway (2015) PDF and <pubmed>11065037</pubmed>

Fetal Development - Length - Weight
Gestational age Fertilization age Length Mass
(LMP) (GA weeks) (weeks) (cm) (g)
8 (embryonic) 6 1.6 (crown to rump) 1
9 7 2.3 2
10 8 3.1 4
11 (fetal) 9 4.1 7
12 10 5.4 14
13 (second trimester) 11 7.4 23
14 12 8.7 43
15 13 10.1 70
16 14 11.6 100
17 15 13 140
18 16 14.2 190
19 17 15.3 240
20 18 16.4
25.6 (crown to heel)
300
21 19 26.7 360
22 20 27.8 430
23 21 28.9 501
24 22 30 600
25 23 34.6 660
26 24 35.6 760
27 25 36.6 875
28 (third trimester) 26 37.6 1005
29 27 38.6 1153
30 28 39.9 1319
31 29 41.1 1502
32 30 42.4 1702
33 31 43.7 1918
34 32 45 2146
35 33 46.2 2383
36 34 47.4 2622
37 35 48.6 2859
38 36 49.8 3083
39 37 50.7 3288
40 38 51.2 3462
41 39 51.7 3597
42 40 51.5 3685
References [6][7][8]
Links: CRL-GA Table | FA-GA-CRL

Historic Embryo CRL

Mall1918-fig01.jpg Streeter1920chart1.jpg
Mall (1918)[1] Streeter (1920) Graph of embryo CRL[2]

Embryo CRL 11 - 23

This graph showing change in CRL during the embryonic period is based upon the Carnegie Collection embryos from a later 1957 paper by Streeter.[3]
Streeter1957 fig01.jpg

Carnegie Stages

Week: 1 2 3 4 5 6 7 8
Carnegie stage: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Carnegie Stages snd CRL
Carnegie Stage CRL (mm)
7 0.4
8 1.0 - 1.5
9 1.5 - 2.5
10 2 - 3.5
11 2.5 - 4.5
12 3 - 5
13 4 - 6
14 5 - 7
15 7 - 9
16 8 - 11
17 11 - 14
18 13 - 17
19 16 - 18
20 18 - 22
21 22 - 24
22 23 - 28
23 27 - 31

Fetal CRL

Ultrasound

Fetal Development - Length - Weight
Gestational age Fertilization age Length Mass
(LMP) (GA weeks) (weeks) (cm) (g)
8 (embryonic) 6 1.6 (crown to rump) 1
9 7 2.3 2
10 8 3.1 4
11 (fetal) 9 4.1 7
12 10 5.4 14
13 (second trimester) 11 7.4 23
14 12 8.7 43
15 13 10.1 70
16 14 11.6 100
17 15 13 140
18 16 14.2 190
19 17 15.3 240
20 18 16.4
25.6 (crown to heel)
300
21 19 26.7 360
22 20 27.8 430
23 21 28.9 501
24 22 30 600
25 23 34.6 660
26 24 35.6 760
27 25 36.6 875
28 (third trimester) 26 37.6 1005
29 27 38.6 1153
30 28 39.9 1319
31 29 41.1 1502
32 30 42.4 1702
33 31 43.7 1918
34 32 45 2146
35 33 46.2 2383
36 34 47.4 2622
37 35 48.6 2859
38 36 49.8 3083
39 37 50.7 3288
40 38 51.2 3462
41 39 51.7 3597
42 40 51.5 3685
References [6][7][8]


Human Embryo No. 131 90 mm CRL

Fetal length change.jpg

Third Trimester CRL

Third trimester Crown-Rump Length graph.jpg


Postnatal

See associated Neural Exam movies - Measuring Newborn head circumference


INTERGROWTH

21st and the World Health Organization Multicentre Growth Reference Study[4]

  • Three recently completed longitudinal cohort studies have developed intrauterine fetal growth charts
    • one in the United States and two international.
  • expert review compares and contrasts the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies, INTERGROWTH-21st and World Health Organization Multicentre Growth Reference Study conclusions
  • area of controversy is whether a single growth reference is representative of growth, regardless of ethnic or country origin. * INTERGROWTH and World Health Organization Fetal studies used a similar approach as the World Health Organization Multicentre Growth Reference Study for infants and children, the aim of which was to create a single international reference for the best physiological growth for children aged 0-5 years.
  • INTERGROWTH found differences in crown-rump length and head circumference among countries but interpreted the differences as not meaningful and presented a pooled standard.
  • recognition of the fact that fetal size is commonly estimated from dimensions (head circumference, abdominal circumference, and femur length) in which there are known differences in children and adults of differing racial/ethnic groups.
  • the percentiles for fetal dimensions and estimated fetal weight varied among the studies.
  • 39 weeks - the 50th percentile for estimated fetal weight
    • Eunice Kennedy Shriver National Institute of Child Health and Human Development Study - 3502 g for whites, 3330 g for Hispanics, 3263 g for Asians, and 3256 for blacks
    • INTERGROWTH - 3186 g
    • World Health Organization Multicentre Growth Reference Study - 3403 g


Links: INTERGROWTH-21st


References

  1. 1.0 1.1 Mall FP. On the age of human embryos. (1918) Amer. J Anat. 23: 397-422.
  2. 2.0 2.1 Streeter GL. Weight, sitting height, head size, foot length, and menstrual age of the human embryo. (1920) Contrib. Embryol., Carnegie Inst. Wash. Publ. , : 143-170.
  3. 3.0 3.1 Streeter GL. Developmental Horizons In Human Embryos Description Or Age Groups XIX, XX, XXI, XXII, And XXIII, Being The Fifth Issue Of A Survey Of The Carnegie Collection. (1957) Carnegie Instn. Wash. Publ. 611, Contrib. Embryol., 36: 167-196.
  4. 4.0 4.1 Grantz KL, Hediger ML, Liu D & Buck Louis GM. (2018). Fetal growth standards: the NICHD fetal growth study approach in context with INTERGROWTH-21st and the World Health Organization Multicentre Growth Reference Study. Am. J. Obstet. Gynecol. , 218, S641-S655.e28. PMID: 29275821 DOI.
  5. Westerway SC, Davison A & Cowell S. (2000). Ultrasonic fetal measurements: new Australian standards for the new millennium. Aust N Z J Obstet Gynaecol , 40, 297-302. PMID: 11065037
  6. 6.0 6.1 Cussen L, Scurry J, Mitropoulos G, McTigue C & Gross J. (1990). Mean organ weights of an Australian population of fetuses and infants. J Paediatr Child Health , 26, 101-3. PMID: 2361065
  7. 7.0 7.1 Hansen K, Sung CJ, Huang C, Pinar H, Singer DB & Oyer CE. (2003). Reference values for second trimester fetal and neonatal organ weights and measurements. Pediatr. Dev. Pathol. , 6, 160-7. PMID: 12548377 DOI.
  8. 8.0 8.1 Archie JG, Collins JS & Lebel RR. (2006). Quantitative standards for fetal and neonatal autopsy. Am. J. Clin. Pathol. , 126, 256-65. PMID: 16891202 DOI.

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Cite this page: Hill, M.A. (2024, March 28) Embryology Crown-Rump Length. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Crown-Rump_Length

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