Dating gestational age by last menstrual period, symphysis‐fundal height, and ultrasound in urban Pakistan

Abstract

Objective-To compare the accuracy of the reported date of the last menstrual period (LMP) with that of symphysis-fundal height (SFH) in the estimation of gestational age (GA), using an ultrasound (US) scan as reference. Results-The mean GA was less by ultrasound than by SFH measurement or the reported LMP, and the mean differences with the US result were statistically significant (P <0.001 for both). At delivery, about 75% of the GA values estimated by SFH measurement were within 7 days and almost 91% were within 14 days of the estimation by ultrasound, compared with 65% and 82% for the GA estimated by the reported LMP. Moreover, using the US as reference, the SFH correctly classified 84% of the term, 68% of the preterm, and 86% of the post-term deliveries (weighted κ = 0.58) compared with the corresponding 79%, 61%, and 55% predicted by the reported LMP (weighted κ = 0.44). Methods-GestationalConclusion-The SFH measurement was found to be more accurate than the reported LMP as a tool to estimate GA and therefore date of delivery, but neither were as accurate as a US scan.

Methods of gestational age assessment influence the observed association between antiretroviral therapy exposure, preterm delivery, and small-for-gestational age infants: a prospective study in Cape Town, South Africa

“…While we expected some differences between LMP-GA and US-GA, 24 the degree of discrepancy was greater than previous reports from high-income countries and other resource-limited settings; 24,25 it was, however, in keeping with previous South African data. 26,27 These inconsistencies suggest the degree and type of error in LMP-GA may depend on demographic characteristics of the study population and data collection methods.…”

Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam

“…Indeed, one study in Bangladesh found LMP estimates of GA were slightly less correlated and concordant with ultrasound than two neonatal examination methods; nevertheless, the authors conclude LMP was valid and clinically preferred to estimate GA in a low-resource setting [13]. Measurement of the symphysis-fundal height is an alternate method that may be used to estimate GA during pregnancy, but there is inconsistent evidence whether symphysis-fundal height performs better than LMP in low- and middle income countries [27]. …”

Consanguinity, prematurity, birth weight and pregnancy loss: a prospective cohort study at four primary health center areas of Karnataka, India

“…1 This observation is consistent with other studies, and may reflect imprecision in gestational evaluation that is common in primary healthcare facilities in rural areas of developing countries where ultrasound is unavailable and where electricity, if available, is unstable. 3,4 In Lebanon, where reliable assessment of gestation was possible, consanguinity was associated with very preterm birth (<33 weeks) but not later preterm birth. 30 Consanguinity was assessed on the basis of self-report, through chart review and interviews.…”

“…2 Although the association between gestation and birth weight is not linear or consistent, birth weight is frequently used as a surrogate measure of gestation because its measurement is more systematically assessed and reliable. 3,4 Low birth weight (LBW), <2500 g, is the most commonly reported birth weight statistics. The incidence of LBW is 28% of the 25 annual million births in India, compared with 7% in developed countries.…”