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Antenatal screening by measurement of symphysis-fundus height
Insights
Symphysis-fundus measurement is a reliable screening tool for detecting intrauterine growth retardation. This simple method accurately identifies pregnancies at risk, aiding in timely intervention for better birth outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Diagnostic Screening
Background:
- Intrauterine growth retardation (IUGR) poses significant risks to fetal well-being.
- Accurate screening methods are crucial for early detection and management of IUGR.
Purpose of the Study:
- To evaluate the utility of symphysis-fundus (SF) measurement as a screening tool for IUGR.
- To assess the reproducibility of SF measurements among different observers and within the same observer.
Main Methods:
- Investigated the reproducibility of SF measurements in two groups of six patients, each measured six times by six different observers.
- Analyzed intraobserver and interobserver coefficients of variation.
- Compared a derived SF measurement chart with existing published data.
- Determined the sensitivity of SF measurement in identifying pregnancies with birth weights below the 10th centile.
Main Results:
- The intraobserver coefficient of variation was 4.6%, and the interobserver coefficient of variation was 6.4%, indicating good reproducibility.
- No significant improvement in measurement consistency was observed with increased experience.
- A SF measurement chart showed similarity to previously published charts.
- SF measurement below the 10th centile identified 64% of pregnancies with subsequent low birth weight for gestational age.
Conclusions:
- Symphysis-fundus measurement is a valuable and reproducible screening test for intrauterine growth retardation.
- A standardized SF measurement chart can be applied across Caucasian populations.
- Incorporation into routine maternity care, such as the "co-operation card," is recommended for improved antenatal surveillance.
Abstract:
A study was undertaken to assess the value of symphysis-fundus measurement as a screening procedure for intrauterine growth retardation. The reproducibility of this measurement was investigated in two groups of six patients, each measured six times by six different observers. The intraobserver coefficient of variation was 4.6% and the interobserver coefficient of variation 6.4%. There was no evidence that experience aided consistency. A chart of symphysis-fundus measurements derived from Cardiff data was found to be similar to others previously published, and one measurement below the 10th centile identified 64% of pregnancies in which the eventual birth weight was below the 10th centile for gestational age. Symphysis-fundus measurement is a useful screening test; one chart could be used for any Caucasian population and should be incorporated into the maternity services "co-operation card."