Self-administered symphysis-fundus measurements analyzed with a novel statistical method for detection of intrauterine growth restriction : a clinical evaluation

• Objective. To assess the ability of self-administered symphysis fundus measurements used with the Shiryaev-Roberts statistical method (SR method) to identify growth-restricted (IUGR) fetuses and compare it with the traditional SF method (symphysis fundus measurements used with a population-based reference curve). Design. Longitudinal study. Setting. Pregnant women attending primary antenatal care centres. Population. From a population of 1 888 women with singleton ultrasound-dated pregnancies, we analyzed data from 1 122 women. Methods. Weekly self-administered SF measurements from gestational week 25 until delivery were analyzed according to the SR method. Neonatal morbidity and small for gestational age (SGA) were used as proxies for IUGR. Small for gestational age was defined as a birthweight less than two standard deviations (SD) and <10th percentile. We assessed the sensitivity of the SR and the SF methods to detect neonatal morbidity and SGA. Main Outcome Measures. Birth-related mortality, respiratory distress, hypoglycemia, Apgar score <= 6 at five minutes, pH <= 7.00 in the umbilical artery, neonatal care, preterm delivery, operative delivery for fetal distress and SGA. Results. For the SR method, the sensitivity for neonatal morbidity was between 6.0 and 36.4%, for SGA <2SD 36.8%, and for SGA <10th percentile 20.9%. The SF method had a sensitivity between 6.0 and 13.8% for neonatal morbidity, 52.3% for SGA <2SD and 28.6% for SGA <10th percentile. Conclusions. The SR and the SF methods had low sensitivities for neonatal morbidity.

Subject headings

LANTBRUKSVETENSKAPER  -- Veterinärmedicin -- Klinisk vetenskap (hsv//swe)

AGRICULTURAL SCIENCES  -- Veterinary Science -- Clinical Science (hsv//eng)

Keyword

Fetal monitoring

symphysis-fundus measurement

self-administration

intrauterine growth restriction

small for gestational age

relative growth

fetal growth

MEDICINE

MEDICIN

fetal growth

Fetal monitoring

intrauterine growth restriction

relative growth

self-administration

small for gestational age

symphysis-fundus measurement

Publication and Content Type

ref (subject category)

art (subject category)