Estimation of gestational age from fundal height: A solution for resource-poor settings

• Main Authors: Lisa J. White, Sue J. Lee, Kasia Stepniewska, Julie A. Simpson, Saw Lu Mu Dwell, Ratree Arunjerdja, Pratap Singhasivanon, Nicholas J. White, Francois Nosten, Rose McGready
• Other Authors: Nuffield Department of Clinical Medicine
• Format: Article
• Published: 2018
• Subjects: Biochemistry, Genetics and Molecular Biology; Chemical Engineering; Engineering; Materials Science
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/13776
• Institution: Mahidol University

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. © 2011 The Royal Society.