Estimation of Gestational Age From Fundal Height: A Solution for Resource-Poor Settings

J R Soc Interface. 2012 Mar 7;9(68):503-10. doi: 10.1098/rsif.2011.0376. Epub 2011 Aug 17.

Abstract

Many women in resource-poor settings lack access to reliable gestational age assessment because they do not know their last menstrual period; there is no ultrasound (US) and methods of newborn gestational age dating are not practised by birth attendants. A bespoke multiple-measures model was developed to predict the expected date of delivery determined by US. The results are compared with both a linear and a nonlinear model. Prospectively collected early US and serial symphysis-pubis fundal height (SFH) data were used in the models. The data were collected from Karen and Burmese women attending antenatal care on the Thai-Burmese border. The multiple-measures model performed best, resulting in a range of accuracy depending on the number of SFH measures recorded per mother (for example six SFH measurements resulted in a prediction accuracy of ±2 weeks). SFH remains the proxy for gestational age in much of the resource-poor world. While more accurate measures should be encouraged, we demonstrate that a formula that incorporates at least three SFH measures from an individual mother and the slopes between them provide a significant increase in the accuracy of prediction compared with the linear and nonlinear formulae also using multiple SFH measures.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Weights and Measures
  • Ethnic Groups
  • Female
  • Gestational Age*
  • Humans
  • Linear Models
  • Myanmar
  • Predictive Value of Tests
  • Prenatal Diagnosis / methods*
  • Pubic Symphysis / anatomy & histology
  • Uterus / anatomy & histology*