The clinical value of measurements of the symphysis-fundus distance and ultrasonic measurements of the biparietal diameter in the diagnosis of intrauterine growth retardation

Cnattingius, Sven; Axelssön, Ove; Lindmark, Gunilla

doi:10.1515/jpme.1985.13.5.227

Cited by 7 publications

(2 citation statements)

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“…Detecting the SGA foetus may enhance the possibilities of identifying the suspected IUGR suspect foetus by following the SFH growth or, if possible, the growth by ultrasound (Persson & Marsal 1978; Cnattingius et al . 1985; Marsal 1992; Marsal et al .…”

Section: Discussionmentioning

confidence: 99%

The impact of adjustment for parity and mid‐upper‐arm circumference on sensitivity of symphysis‐fundus height measurements to predict SGA foetuses in Mozambique

Challis

Osman

Nordahl

et al. 2003

Tropical Med Int Health

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Summarybackground With a new symphysis-fundus height (SFH) growth chart, based on Mozambican women with ultrasound-dated singleton pregnancies, the aim was to examine the possibility to enhance sensitivity of predicting small for gestational age (SGA) newborns by attempts to adjust the chart for parity and for mid-upper-arm circumference (MUAC).methods Two antenatal clinics were chosen in the suburban area of Maputo City. A cohort of 904 consecutively recruited antenatal clients was followed until birth. Gestational age was determined by ultrasound at enrolment. The growth of the SFH was measured every 2-3 weeks. Women with multiple pregnancy or with gestational age >21 weeks at enrolment were excluded. Attempts were made to adjust SFH measurements for parity and MUAC by developing a mathematical model to increase sensitivity of the SFH method to predict a foetus being SGA.results Parous women had on average 0.5-1 cm higher SFH readings than nulliparous women. Women with a body mass index (BMI) <19 and women with BMI >27 had approximately 1 cm lower and 1 cm higher readings, respectively, compared with women of normal BMI. There was a significant correlation between BMI and MUAC (r ¼ 0.621; P < 0.001). The usefulness of SFH measurements to predict SGA newborns was analysed. The sensitivity was 49%, the specificity was 66%, the positive predictive value was 14% and the negative predictive value, 93%. By using the correlation between BMI and MUAC we tried to find a simple and useful method to improve the sensitivity of SFH to detect SGA foetuses. By reducing the SFH measurement by 1 cm for women with MUAC >29 and by 1 cm for multiparous women the sensitivity raised to 65% at the expense of reducing the specificity to 51%. Using a linear function of BMI, MUAC and parity to adjust the SFH measurement for each individual woman, it was possible to get a sensitivity of 70% with a corresponding specificity of 56%.conclusion By using BMI, MUAC and parity, it might be possible to improve the sensitivity of the SFH growth chart in predicting newborn being SGA but mostly at the expense of specificity.keywords symphysis-fundus height, small for gestational age, body mass index, mid-upper-arm circumference, Mozambique correspondence Dr Kenneth Challis,

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Section: Discussionmentioning

confidence: 99%

The impact of adjustment for parity and mid‐upper‐arm circumference on sensitivity of symphysis‐fundus height measurements to predict SGA foetuses in Mozambique

Challis

Osman

Nordahl

et al. 2003

Tropical Med Int Health

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“…Cnattingus S et al, in their study have shown that SFH measurment has a sensitivity of 100 %, specificity of 92% and a NPV of 100%. 7 Pillay P et al, found that the sensitivity of the Gravidogram was 74.1%, specificity was 95.9%, PPV was 78.4% and NPV was 94.8%. 8 Mc Dermott et al, estimated the average sensitivity of detecting IUGR using SFH to be 65% with a false positive rate of 50%.…”

Section: Discussionmentioning

confidence: 99%

Validity of clinical and sonographic diagnosis of IUGR: a comparative study

Marhatta

Kaul

2017

Int J Reprod Contracept Obstet Gynecol

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Background: IUGR refers to a condition in which a fetus is unable to grow to its genetically predetermined potential size. It is the major cause of perinatal morbidity and mortality in developing countries. The present study was conducted to compare the validity of clinical diagnosis against sonographic diagnosis of IUGR. Methods: This study was conducted in the department of Obstetrics and Gynaecology, SMGS Hospital, Jammu from Octobar 2013 to September 2014. It included 247 women with singleton pregnancies with longitudinal lie. They underwent serial clinical assessment using SFH, AG and weight gain along with Ultrasound and Doppler of Umbilical & Middle cerebral artery. Birth weight of newborns was measured at delivery and was thereafter correlated with clinical and sonographic diagnosis; to access their validity. Results: Sensitivity of SFH in detecting IUGR was 71.4% against 75.7% by Ultrasound and was highest with Doppler of 82.9%. Specificity was 43.6% by SFH, 64.3% by Ultrasound and 86.2% by Doppler. Doppler also had the highest NPV of 92.6% against 79.1% by SFH and 86.8% by Ultrasound. The combination of clinical and ultrasound diagnosis increased the sensitivity to 95.2% and NPV to 95.91%. However, the combination of clinical and Doppler assessments did not significantly change the outcome. Conclusions: Doppler is the single best investigation available for diagnosing IUGR with a high specificity and NPV. However, importance of clinical diagnosis cannot be overlooked, especially in a developing country with limited resources like ours. In the absence of Doppler combined clinical and Ultrasound assessment should be considered.

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