Open AccessSelf‐administered symphysis–fundus measurements analyzed with a novel statistical method for detection of intrauterine growth restriction: a clinical evaluation
Author(s) -
BERGMAN EVA,
AXELSSON OVE,
PETZOLD MAX,
SONESSON CHRISTIAN,
KIELER HELLE
Publication year - 2011
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2011.01181.x
Subject(s) - medicine , small for gestational age , obstetrics , percentile , gestational age , population , fundus (uterus) , umbilical artery , respiratory distress , apgar score , intrauterine growth restriction , pregnancy , gestation , pediatrics , surgery , statistics , genetics , mathematics , environmental health , biology
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.