Symphysis‐fundus growth measurement followed by umbilical artery Doppler velocimetry to screen for placental insufficiency

Theron, Gerhard; Theron, A.M; Odendaal, Hein J.

doi:10.1016/s0020-7292(02)00300-4

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…The intended benefits of this method can be difficult to bring across, and there are no studies that show improved perinatal outcome from its use in settings similar to that of Gutu, where follow‐up investigations for confirming a diagnosis of abnormal fetal growth or for monitoring the fetal condition are not available. Previous studies in Africa have mainly discussed fundal height measurement as cheap and easy to perform but not the necessary resources for follow up of abnormal findings, even though in some affluent settings, more elaborate technologies will be available 32–35 . Fundal height measurement has low sensitivity and specificity, necessitating further investigation such as ultrasound which is not available in many low‐resource settings.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies in Africa have mainly discussed fundal height measurement as cheap and easy to perform but not the necessary resources for follow up of abnormal findings, even though in some affluent settings, more elaborate technologies will be available. [32][33][34][35] Fundal height measurement has low sensitivity and specificity, necessitating further investigation such as ultrasound which is not available in many lowresource settings. The diagnostic ability for twin pregnancy, which this method should increase, did not change in either of these trials.…”

Section: Discussionmentioning

confidence: 99%

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Randomised controlled trial of two antenatal care models in rural Zimbabwe

Majoko¹,

Munjanja²,

Nyström³

et al. 2007

BJOG

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Objective To compare a five-visit antenatal care (ANC) model with specified goals with the standard model in a rural area in Zimbabwe.Design Cluster randomised controlled trial with the clinic as the randomisation unit.Setting Primary care setting in a developing country where care was provided by nurse-midwives.Population Women booking for ANC in the clinics were eligible.Main outcome measures Number of antenatal visits, antepartum and intrapartum referrals, utilization of health centre for delivery and perinatal outcomes.Methods Twenty-three rural health centres were stratified prior to random allocation to the new (n = 11) or standard (n = 12) model of care.Results We recruited 13 517 women (new, n = 6897 and standard, n = 6620) in the study, and 78% (10 572) of their pregnancy records were retrieved. There was no difference in median maternal age, parity and gestational age at booking between women in the standard model and those in the new model. The median number of visits was four for both models. The proportion of women with five or less visits was 77% in the new and 69% in the standard model (OR 1.5; 95% CI 1.08-2.2). The likelihood of haemoglobin testing was higher in the new model (OR 2.4; 95% CI 1.0-5.7) but unchanged for syphilis testing. There were fewer intrapartum transfers (5.4 versus 7.9% [OR 0.66; 95% CI 0.44-0.98]) in the new model but no difference in antepartum or postpartum transfers. There was no difference in rates of preterm delivery or low birthweight. The perinatal mortality was 25/1000 in standard model and 28/1000 in new model. ConclusionIn Gutu district, a focused five-visit schedule did not change the number of contacts but was more effective as expressed by increased adherence to procedures and better use of institutional health care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Randomised controlled trial of two antenatal care models in rural Zimbabwe

Majoko¹,

Munjanja²,

Nyström³

et al. 2007

BJOG

View full text Add to dashboard Cite

show abstract

“…However, in a low risk pregnant population without prior history of stillbirth, growth restriction or hypertension, the most reliable way of screening for ischaemic placental disease is with fundal growth. Poor fundal growth as measured by serial SF growth are detected in 5.4% of low risk pregnancies in this population and Doppler tests of the umbilical artery (UA) in these patients are reliable to detect those babies at risk for placental insufficiency [ 11 ]. More importantly, the specificity of Doppler in this setup is high (97%); making it an ideal surveillance test in a low resource setting [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Introducing a Mobile-Connected Umbilical Doppler Device (UmbiFlow™) into a Primary Care Maternity Setting: Does This Reduce Unnecessary Referrals to Specialised Care? Results of a Pilot Study in Kraaifontein, South Africa

Mufenda

Gebhardt

Rooyen³

et al. 2015

PLoS ONE

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ObjectivesUmbiFlow™ is a mobile-connected Doppler device that utilises a continuous waveform to measure resistance in the umbilical artery. The main aim of this pilot study was to determine whether the use of UmbiFlow™ for umbilical artery Doppler in patients with a suspected decreased symphysis fundal (SF) growth could safely lead to a decreased number of patients requiring referral to a more specialised level of care. A secondary aim of the study was to evaluate the effectiveness of UmbiFlow™ Doppler as a screening tool for concealed placental insufficiency in late bookers by using a single screening cut-off value that will be abnormal for any gestation >28 weeks.MethodsThe cohort comprised two groups of patients: The first group included all follow-up patients with suspected intra-uterine growth restriction (a decreased symphysis-fundus measurement based on serial assessment) who underwent on-site UmbiFlow™Doppler testing performed by the midwife directly after the clinical examination. The second group included late bookers, where gestation was uncertain; but estimated >28 weeks based on clinical grounds. This group was comprised of unselected patients who report to antenatal care late for the first time and received an UmbiFlow™Doppler test for concealed placental insufficiency.ResultsUmbiFlow™Doppler could reduce the number of false referrals to hospital by 55%. A single UmbiFlow™Doppler test in late bookers appeared to identify a group of women at moderate risk of lower birth weight babies.

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Current Awareness in prenatal diagnosis

2003

Prenatal Diagnosis

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre‐implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted

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Symphysis‐fundus growth measurement followed by umbilical artery Doppler velocimetry to screen for placental insufficiency

Cited by 4 publications

References 2 publications

Randomised controlled trial of two antenatal care models in rural Zimbabwe

Randomised controlled trial of two antenatal care models in rural Zimbabwe

Introducing a Mobile-Connected Umbilical Doppler Device (UmbiFlow™) into a Primary Care Maternity Setting: Does This Reduce Unnecessary Referrals to Specialised Care? Results of a Pilot Study in Kraaifontein, South Africa

Current Awareness in prenatal diagnosis

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