Dataset Information

Combination of Fundal Height and Ultrasound to Predict Small for Gestational Age at Birth.

ABSTRACT:

Objective

The objective of the study was to determine whether adding longitudinal measures of fundal height (FH) to the standard cross-sectional FH to trigger third trimester ultrasound estimated fetal weight (EFW) would improve small for gestational age (SGA) prediction.

Study design

We developed a longitudinal FH calculator in a secondary analysis of a prospective cohort study of 1,939 nonobese pregnant women who underwent serial FH evaluations at 12 U.S. clinical sites. We evaluated cross-sectional FH measurement ≤ -3 cm at visit 3 (mean: 32.0 ± 1.6 weeks) versus the addition of longitudinal FH up to and including visit 3 to trigger an ultrasound to diagnose SGA defined as birthweight <10th percentile. If the FH cut points were not met, the SGA screen was classified as negative. If FH cut points were met and EFW was <10th percentile, the SGA screen was considered positive. If EFW was ≥10th percentile, the SGA screen was also considered negative. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were computed.

Results

In a comparison of methods, 5.8% of women were classified as at risk of SGA by both cross-sectional and longitudinal classification methods; cross-sectional FH identified an additional 4.0%, and longitudinal fundal height identified a separate, additional 4.5%.Using cross-sectional FH as an ultrasound trigger, EFW had a PPV and NPV for SGA of 69 and 92%, respectively. After adding longitudinal FH, PPV increased to 74%, whereas NPV of 92% remained unchanged; however, the number of women who underwent triggered EFW decreased from 9.7 to 5.7%.

Conclusion

An innovative approach for calculating longitudinal FH to the standard cross-sectional FH improved identification of SGA birthweight, while simultaneously reducing the number of triggered ultrasounds. As an essentially free-of-charge screening test, our novel method has potential to decrease costs as well as perinatal morbidity and mortality (through better prediction of SGA).

Key points

· We have developed an innovative calculator for fundal height trajectory.. · Longitudinal fundal height improves detection of SGA.. · As a low cost screening test, the fundal height calculator may decrease costs and morbidity through better prediction of SGA..

SUBMITTER: Grantz KL

PROVIDER: S-EPMC8802337 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Publications

Combination of Fundal Height and Ultrasound to Predict Small for Gestational Age at Birth.

Grantz Katherine L KL Ortega-Villa Ana M AM Pugh Sarah J SJ Bever Alaina A Grobman William W Newman Roger B RB Owen John J Wing Deborah A DA Albert Paul S PS

American journal of perinatology 20210503 2

<h4>Objective</h4>The objective of the study was to determine whether adding longitudinal measures of fundal height (FH) to the standard cross-sectional FH to trigger third trimester ultrasound estimated fetal weight (EFW) would improve small for gestational age (SGA) prediction.<h4>Study design</h4>We developed a longitudinal FH calculator in a secondary analysis of a prospective cohort study of 1,939 nonobese pregnant women who underwent serial FH evaluations at 12 U.S. clinical sites. We eval ...[more]

PMID: 33940642

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Dataset Information

Combination of Fundal Height and Ultrasound to Predict Small for Gestational Age at Birth.

Objective

Study design

Results

Conclusion

Key points

Publications

Combination of Fundal Height and Ultrasound to Predict Small for Gestational Age at Birth.

Similar Datasets

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