A survey of methods used to measure symphysis fundal height

Griffiths, A; Pinto, Ana Marta; Margarit, Lavinia

doi:10.1080/01443610802462092

Cited by 10 publications

(10 citation statements)

References 16 publications

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“…Moreover, unlike Tetschke et al (2016), our work did not require high-resolution input signals, making the implementation of the approach described here feasible in LMICs. Notably, our GA estimations were lower than the 6 weeks error associated with symphysis-fundal height, which is the common dating method used in LMICs to detect IUGR (Griffiths et al, 2008).…”

Section: Interpretations Of Findingsmentioning

confidence: 66%

“…However, the symphysis-fundal height method lacks significant evidence to recommend its widely use in LMICs (World Health Organization, 2016). Moreover, previous studies have noted that the SHF has exhibited a large error of ±6 weeks for estimating GA (Griffiths et al, 2008). New approaches are, therefore, still needed to provide reproducible and low-cost assessment for detecting abnormal growth in settings in which ultrasound images, taken by trained operators, are not available.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Proxy for Detecting IUGR Based on Gestational Age Estimation in a Guatemalan Rural Population

Valderrama

Marzbanrad

Hall-Clifford

et al. 2020

Front. Artif. Intell.

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In-utero progress of fetal development is normally assessed through manual measurements taken from ultrasound images, requiring relatively expensive equipment and well-trained personnel. Such monitoring is therefore unavailable in low-and middle-income countries (LMICs), where most of the perinatal mortality and morbidity exists. The work presented here attempts to identify a proxy for IUGR, which is a significant contributor to perinatal death in LMICs, by determining gestational age (GA) from data derived from simple-to-use, low-cost one-dimensional Doppler ultrasound (1D-DUS) and blood pressure devices. A total of 114 paired 1D-DUS recordings and maternal blood pressure recordings were selected, based on previously described signal quality measures. The average length of 1D-DUS recording was 10.43 ± 1.41 min. The min/median/max systolic and diastolic maternal blood pressures were 79/102/121 and 50.5/63.5/78.5 mmHg, respectively. GA was estimated using features derived from the 1D-DUS and maternal blood pressure using a support vector regression (SVR) approach and GA based on the last menstrual period as a reference target. A total of 50 trials of 5-fold cross-validation were performed for feature selection. The final SVR model was retrained on the training data and then tested on a held-out set comprising 28 normal weight and 25 low birth weight (LBW) newborns. The mean absolute GA error with respect to the last menstrual period was found to be 0.72 and 1.01 months for the normal and LBW newborns, respectively. The mean error in the GA estimate was shown to be negatively correlated with the birth weight. Thus, if the estimated GA is lower than the (remembered) GA calculated from last menstruation, then this could be interpreted as a potential sign of IUGR associated with LBW, and referral and intervention may be necessary. The assessment system may, therefore, have an immediate impact if coupled with suitable intervention, such as nutritional supplementation. However, a prospective clinical trial is required to show the efficacy of such a metric in the detection of IUGR and the impact of the intervention.

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Section: Interpretations Of Findingsmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

A Proxy for Detecting IUGR Based on Gestational Age Estimation in a Guatemalan Rural Population

Valderrama

Marzbanrad

Hall-Clifford

et al. 2020

Front. Artif. Intell.

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“…Fundal height was measured in centimetres first from the fundus to the top of the symphysis pubis and second from the symphysis pubis to the top of the fundus. Measurements were compared for consistency and then averaged for analyses to improve predictive accuracy by being inclusive of varying measurement techniques . Additional fundal heights were abstracted from the prenatal records.…”

Section: Methodsmentioning

confidence: 99%

“…Measurements were compared for consistency and then averaged for analyses to improve predictive accuracy by being inclusive of varying measurement techniques. 18 Additional fundal heights were abstracted from the prenatal records. Mid-upper arm circumference was measured using a non-stretchable linen tape to the nearest 0.1 cm.…”

Section: Methodsmentioning

confidence: 99%

Estimating gestational age at birth from fundal height and additional anthropometrics: a prospective cohort study

Pugh

Ortega-Villa

Grobman

et al. 2018

BJOG

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“…Measurement of fundal height for fetal growth assessment is recommended above other methods, including comparing uterine height with abdominal landmarks and measurement of abdominal circumference (Engstrom and Sittler 1993;NICE 2008). However, the method is recognised as flawed, with rates of sensitivity cited at 40-73% and varying degrees of inter-and intraobserver variation (Griffiths et al 2008). A recent review showed that there is insufficient evidence to fully evaluate the efficacy of symphysis-fundal height measurement, but warned it would be unwise to abandon its use in the absence of proven alternatives (Neilson 2009).…”

Section: Introductionmentioning

confidence: 97%

Is the use of symphysis-fundal height measurement and ultrasound examination effective in detecting small or large fetuses?

Hargreaves¹,

Cameron²,

Edwards³

et al. 2011

Journal of Obstetrics and Gynaecology

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We investigated the accuracy of using symphysis pubis-fundal height measurement and ultrasonically derived estimation of fetal weight for identifying small-for-gestational-age (SGA) and large-for-gestational-age (LGA) fetuses. A retrospective cohort study was performed using computerised records of all non-diabetic women referred for an ultrasound growth scan (US) with clinically suspected SGA or LGA singleton fetuses from 35 weeks' gestation between October 2008 and March 2009 (n = 185). Birth weight data were also collected for all births over the study period (n = 3200). One-third (34%) of ultrasound estimated fetal weights were inaccurate by >10%. However, an inaccurate ultrasound estimation did not significantly increase the likelihood of spontaneous or induced onset of labour or delivery by caesarean section. Most (79%) growth scans were performed on well-grown fetuses. The majority (80%) of SGA and LGA babies in our cohort were not identified by clinicians during routine antenatal care. From 3,200 live births, there were a total of 59 infants weighing <2,500 g or >5,000 g. Of these, only 12 had been referred for an ultrasound growth scan, indicating that abdominal palpation and fundal height measurement has a 20% sensitivity in detecting SGA or LGA fetuses. Of the 12, four were detected using ultrasound, indicating a 33% detection rate. Although ultrasound has a slightly higher sensitivity, neither clinical examination using fundal height measurements nor 3rd trimester ultrasound examinations are effective at detecting SGA or LGA fetuses.

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A survey of methods used to measure symphysis fundal height

Cited by 10 publications

References 16 publications

A Proxy for Detecting IUGR Based on Gestational Age Estimation in a Guatemalan Rural Population

A Proxy for Detecting IUGR Based on Gestational Age Estimation in a Guatemalan Rural Population

Estimating gestational age at birth from fundal height and additional anthropometrics: a prospective cohort study

Is the use of symphysis-fundal height measurement and ultrasound examination effective in detecting small or large fetuses?

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