Fallacy of the Fundal Height

Beazley, J. M.; Underhill, Rosemary

doi:10.1136/bmj.4.5732.404

Cited by 113 publications

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“…Robinson noted that uterine size determination by bimanual examination produced incorrect assessments by more than two weeks in over 30% of patients [6]. Similarly, fundal height estimation does not provide a reliable guide to predicting gestational age with up to eight weeks variation in gestational age for any particular fundal height measurement during the second and third trimesters [7]. In addition, quickening or initial perception of fetal movement can vary greatly among women.…”

Section: Clinical Methods For Determining Gestational Agementioning

confidence: 97%

Sonographic determination of gestational age

Kalish

Chervenak

2005

The Ultrasound Review of Obstetrics & Gynecology

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Objective. To review current evidence regarding sonographic determination of gestational age. Methods. We reviewed current and available data to evaluate optimal methods of gestational age determination. Results. First trimester estimates of gestational age based on crown-rump length and second trimester estimates of gestational age based on composite biometry are very accurate with an absolute error of less than 5 days in the first trimester and 7 days in the second trimester in most cases. Conclusion. Ultrasound is an accurate and useful modality for assessment of gestational age in the first and second trimester of pregnancy and, as a routine part of prenatal care, can greatly impact obstetric management and improve antepartum care.

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Section: Clinical Methods For Determining Gestational Agementioning

confidence: 97%

Sonographic determination of gestational age

Kalish

Chervenak

2005

The Ultrasound Review of Obstetrics & Gynecology

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“…In addition, traditional methods for appreciating fetal development (inspection and fundal height measurement) are unreliable [18,19]. It is therefore necessary to use reliable formulas for echographic fetal weight estimation, as weight in association with gestational age and markers of fetal well-being, may play an important role in the obstetrical management.…”

Section: Discussionmentioning

confidence: 99%

Validity of Sonographic Formulas for Estimating Fetal Weight below 1,250 g: A Series of 119 Cases

Jouannic

Grangé²,

Goffinet³

et al. 2001

Fetal Diagn Ther

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Objective: The aim of this study was to determine the accuracy of sonographic methods for estimating fetal weight <1,250 g on the basis of ten published formulas falling into two principal categories: general formulas applied to all fetuses, and formulas specifically developed for very-low-weight fetuses. Methods: Recent biometric data (obtained less than 7 days before birth) on 119 fetuses weighing <1,250 g were used retrospectively. Estimated fetal weights derived from ten published formulas were compared to actual weights. For each equation, the errors in predicting fetal weight were used to calculate mean percentage error and standard deviation of the mean error. The t test was used to determine whether the mean errors were significatively different from zero. The F test was used to determine if there were significant differences in the standard deviation of the mean errors. Results: The mean birth weight of infants was 956 ± (SD) 183 g at a gestational age of 29 ± (SD) 2.3 weeks. The best three formulas were the Hadlock, Sabbagha and Mielke which generated a mean error of –0.25, 2.81 and 0.29 not statistically different from zero with standard deviations of 13.02, 9.14 and 11.96, which were not statistically different. Conclusion: In our population of very-low-birth-weight infants, the use of specific formulas targeted to those fetuses does not provide a more accurate estimation of fetal weight.

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“…Beazley and Underhill reported wide patient variation of their measurements and questioned the clinical relevance of this parameter 8 . Belizan et al and Calvert et al, on the contrary, found the procedure to be simple inexpensive and reliable method of determining fetal age, and a useful screening test for intrauterine growth restriction 9,10 .…”

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confidence: 99%

Symphysio-Fundal Height Measurement as a Means of Gestational Age Assessment in the Second Half of Pregnancy at the University of Ilorin Teaching Hospital, Nigeria

Adewale

Ijaiya

2013

Bangladesh J Obstet Gynaecol

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Background: Accurate determination of gestational age (GA) is an important part of obstetric care. Objective: The aim of this study is to determine the reliability of symphsio-fundal height (SFH) measurement in assessing gestational age in the second half of pregnancy.Method: A total of 390 pregnant Nigerian women carrying uncomplicated singleton pregnancies between the gestational age of 20-40 weeks had SFH measurements done at the antenatal clinic, and ultrasonic biparietal diameter (BPD) and femur length (FL) determination at the fetal assessment unit, maternity wing of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The patients were followed up subsequently and managed till delivery. At delivery each baby was examined within the first 48 hours of life and gestational age at birth was assigned using the Ballard method. Result: Of the 390 patients studied, SFH correctly assessed GA in 80% compared to 81.3% for BPD (P = 0.43), 82.1% for FL (P = 0.41), 84.1% for BPD and FL (p = 0.35). There is no significant difference in the sensitivity of SFH 93.1% and ultrasound 97.9%. There is also no significant difference in the margin of error between the true gestational ages obtained by the two methods (SFH 15-41days Vs ultrasound 15-33days). Combined ultrasound parameters(BP & FL),FL, BPD and SFH were progressively less closely correlated with the age of the fetus assessed by Ballard method. Conclusion: This study showed that accurate measurement of the SFH is a reliable method of gestational age assessment in the second half of pregnancy DOI: http://dx.doi.org/10.3329/bjog.v26i1.13751 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(1) : 3-9

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Fallacy of the Fundal Height

Cited by 113 publications

References 0 publications

Sonographic determination of gestational age

Sonographic determination of gestational age

Validity of Sonographic Formulas for Estimating Fetal Weight below 1,250 g: A Series of 119 Cases

Symphysio-Fundal Height Measurement as a Means of Gestational Age Assessment in the Second Half of Pregnancy at the University of Ilorin Teaching Hospital, Nigeria

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