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

Hargreaves, K.; Cameron, M.; Edwards, H.; Gray, Richard; Deane, K.

Abstract

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 5,000 Å 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. © 2011 Informa UK, Ltd.

• Journal Article Type: Article
• Publication Date: Jul 1, 2011
• Journal: Journal of Obstetrics and Gynaecology
• Print ISSN: 0144-3615
• Electronic ISSN: 1364-6893
• Publisher: Taylor & Francis
• Peer Reviewed: Peer Reviewed
• Volume: 31
• Issue: 5
• Pages: 380-383
• DOI: https://doi.org/10.3109/01443615.2011.567343
• Keywords: estimated fetal weight, fetus, fundal height, labour outcome, LGA, SGA, ultrasound
• Public URL: https://uwe-repository.worktribe.com/output/960658
• Publisher URL: http://dx.doi.org/10.3109/01443615.2011.567343