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Updated: Jun 13, 2026
High Frequency Ultrasound for the Analysis of Fetal and Placental Development In Vivo
Published on: November 8, 2018
A prospective comparison of clinical and ultrasonic methods of predicting normal and abnormal fetal growth
F E Okonofua1, S O Ayangade, R C Chan
1Academic Department of Obstetrics and Gynaecology, Royal Free Hospital School of Medicine, London, UK.
Insights
Symphysial-fundal height (SFH) is a good screening tool for normal fetal growth but less sensitive than ultrasound for diagnosing small-for-gestational age (SGA) infants or macrosomia. SFH should remain a routine antenatal screening test for abnormal fetal growth.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Diagnostic Imaging
Background:
- Accurate antenatal diagnosis of fetal growth is crucial for optimizing perinatal outcomes.
- Symphysial-fundal height (SFH) measurement and ultrasound biometry are common methods for assessing fetal growth.
- Discrepancies between antenatal assessment and postnatal classification can impact clinical management.
Purpose of the Study:
- To compare the diagnostic accuracy of SFH measurements and ultrasound biometry (fetal biparietal diameter and abdominal circumference) for detecting altered fetal growth.
- To evaluate the effectiveness of these methods in identifying small-for-gestational age (SGA) and large-for-gestational age (LGA) infants.
Main Methods:
- A prospective study involving 100 pregnant patients.
- Simultaneous use of SFH charts and ultrasound biometry for antenatal growth assessment.
- Postnatal classification of infants as SGA, appropriate for gestational age (AGA), or LGA based on birthweight.
Main Results:
- SFH measurement demonstrated comparable accuracy to ultrasound in predicting normal fetal growth.
- Ultrasound was more sensitive than SFH in diagnosing SGA infants.
- SFH was least sensitive for detecting macrosomia (LGA).
Conclusions:
- SFH measurement is a valuable and cost-effective screening tool for abnormal fetal growth and should be maintained in routine antenatal care.
- Ultrasound biometry offers superior sensitivity for detecting SGA and macrosomia, complementing SFH screening.
Abstract:
Charts of symphysial-fundal height (SFH) and ultrasound growth of fetal biparietal diameter (BPD) and abdominal circumference (FAC) were used simultaneously for the antenatal diagnosis of altered fetal growth in 100 patients. After delivery, infants were classified as small-for-gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) by birthweight and the postnatal diagnoses compared to antenatal diagnoses. The results indicate that although SFH is as good as ultrasound in predicting normal fetal growth, it is less sensitive than ultrasound for the diagnosis of SGA infants and even less so for macrosomia. It is concluded that SFH should be retained or instituted as a routine screening test for abnormal fetal growth.
