Prediction of gestational age with symphysis-fundal height and estimated uterine volume in a pregnancy cohort in Sylhet, Bangladesh
Open Access
- 9 March 2020
- Vol. 10 (3), e034942
- https://doi.org/10.1136/bmjopen-2019-034942
Abstract
Objective To improve the accuracy of the prediction of gestational age (GA) before birth with the standardised measurement of symphysis-fundal height (SFH), estimation of uterine volume, and statistical modelling including maternal anthropometrics and other factors. Design Prospective pregnancy cohort study. Setting Rural communities in Sylhet, Bangladesh. Participants 1516 women with singleton pregnancies with early pregnancy ultrasound dating (37 weeks gestation. An estimated uterine volume (EUV) was calculated from these measures. Data on pregnancy characteristics and other maternal anthropometrics were also collected. Primary outcome measure GA at subsequent ANC visits, as defined by early ultrasound dating. Results 1486 (98%) women had at least one subsequent ANC visit, 1102 (74%) women had two subsequent ANC visits, and 748 (50%) had three visits. Using the common clinical practice of approximating the GA (in weeks) with the SFH measurement (cm), SFH systematically underestimated GA in late pregnancy (mean difference −4.4 weeks, 95% limits of agreement −12.5 to 3.7). For the classification of GA Conclusions We were unable to predict GA with a high degree of accuracy before birth using maternal anthropometric measures and other available maternal characteristics. Efforts to improve GA dating in low- and middle-income countries before birth should focus on increasing coverage and training of ultrasonography. Trial registration number NCT01572532Funding Information
- United States Agency for International Development (AID-OAA-A-14-00049)
This publication has 24 references indexed in Scilit:
- International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st ProjectThe Lancet, 2014
- International standards for early fetal size and pregnancy dating based on ultrasound measurement of crown–rump length in the first trimester of pregnancyUltrasound in Obstetrics & Gynecology, 2014
- Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?The Lancet, 2014
- Born Too Soon: The global epidemiology of 15 million preterm birthsReproductive Health, 2013
- Estimation of gestational age from fundal height: a solution for resource-poor settingsJournal of The Royal Society Interface, 2011
- Obstetric ultrasound scanning by local health workers in a refugee camp on the Thai–Burmese borderUltrasound in Obstetrics & Gynecology, 2009
- Symphysis-fundal height measurement in pregnancyEmergencias, 1998
- Fetal crown-rump length: reevaluation of relation to menstrual age (5-18 weeks) with high-resolution real-time US.Radiology, 1992
- Estimation of Fetal Weight in Utero from Symphysisfundal Height and Abdominal Girth MeasurementsAustralian and New Zealand Journal of Obstetrics and Gynaecology, 1985
- The extent and antecedents of uncertain gestationBJOG: An International Journal of Obstetrics and Gynaecology, 1985