Tape measurement of symphysis‐fundal height in twin pregnancies

Abstract

Summary. We hypothesized that tape measurement of symphysis‐fundal height could be useful in detecting multiple pregnancies, and in such cases in predicting preterm labour and identifying small‐for‐gestationalage (SGA) fetuses. Although mean fundal height is substantially greater in twin than in singleton pregnancies, the value of the technique to detect multiple pregnancies may be limited because combined birthweight is less and the frequency of SGA fetuses is greater in undiagnosed than in diagnosed twin pregnancies. We found no evidence that the measured fundal height is greater in pregnancies going on to preterm delivery, and we suggest that the commonly accepted theory that the high rate of preterm labour in twin pregnancies results simply from uterine overdistension be reappraised. Nevertheless, fundal height measurement was of value in identifying pregnancies in which both babies were SGA and is therefore recommended as a simple, inexpensive and non‐invasive technique.

Single pre‐delivery symphysis‐fundal height measurement as a predictor of birthweight and multiple pregnancy

“…One explanation could be the motivation, training and regular surveillance of the health workers involved. Detection rate, false positive rate and the odds of being affected, given a positive result in this study of single predelivery symphysis-fundal height measurements in detecting low birthweight and macrosomia or twin pregnancy are comparable to results from serial measurements for the detection of fetal growth retardation, macrosomia and multiple pregnancy (Westin 1977;Belizan et al 1978;Quaranta et al 1981 ;Calvert et al 1982;Rosenberg et al 1982;Cnattingius et al 1984;Mathai et al 1987;Neilson et al 1988). Also, in agreement with other symphysisfundal height measurement studies, we obtained good results on false positive rates and relatively moderate test performances for detection rates and the odds of being affected, given a positive result.…”

“…Tape measurement of symphysis‐fundal height has been suggested as a screening test for the detection of fetal growth retardation, macrosomia and multiple pregnancy (Westin 1977; Belizan et al 1978; Quaranta et al 1981; Calvert et al 1982; Cnattingius et al 1984; Mathai ef al. 1987; Pearce & Campbell 1987; Neilson et al 1988). It is regarded as a simple, inexpensive and non‐invasive procedure.…”

Randomised controlled trial of two antenatal care models in rural Zimbabwe

“…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.…”

“…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.…”

Fundal height measurement *1Part 4—Accuracy of clinicians' identification of the uterine fundus during pregnancy

“…Fundal height measurements are used in many clinical settings to evaluate the appropriateness of uterine size for the number of gestational weeks. Abnormal fundal height measurements can indicate the presence of several serious pregnancy complications such as fetal growth disturbances (1–3), multiple gestations (2, 4, 5), amniotic fluid volume disorders (2, 6), hydatidiform moles (7), and errors in estimating the gestational interval. Thus, the ability to obtain accurate fundal height measurements is essential for safe clinical practice.…”