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Fundal height measurement as an antenatal screening method.

This article discusses a study that was undertaken to assess the value of symphisis-fundus measurement as a screening procedure for intra-uterine growth retardation (IUGR) and to see whether values derived from a Caucasian population could be used for an African population. The problem addressed is the lack of sophisticated methods to detect IUGR in developing countries generally and the underuse of this simple method in Africa possibly as a result of a lack of agreed principles. Of an initial study group of 510 women visiting an antenatal clinic in Lesotho 122 who eventually delivered in the hospital were tested. Information on fundal height gestational age height postpartum weight parity and age of the mother was collected. A retrospective calculation determined which fundal height corresponded with which gestational age. The graph was then compared with a graph from a Guatemalan population and a Nigerian Population. Of the 122 women 25% were primipara. Mean height was 156.6 cm. Mean postdelivery weight of 59.2 Kg is comparable to that of well-nourished Caucasian women. 10 infants were small 10 large and 102 average for gestational age. The values derived from an African population were found to be lower than the Caucasian values. A common chart can therefore not be used. The predictive value was found to be high. 1 measurement below the 10th percentile identified 70% of pregnancies in which the eventual birthweight was below the 10th percentile for gestational age. Symphisis-fundus measurement is a useful screening test for diagnosing IUGR.