NJOG 2011 Nov-Dec; 6 (2): 27-32 ORIGINAL ARTICLE Symphysio-Fundal Height Measurement as a Means of Gestational Age Assessment in the Second Half of Pregnancy at the University of Ilorin Teaching Hospital, Nigeria Folorunsho B. Adewale 1, Munir deen A. Ijaiya 2 1 Department of Obs/Gyn, Federal Medical Centre, Bida, 2 University of Ilorin Teaching Hospital, Maternity Wing Aims: Accurate determination of gestational age (GA) is an important part of obstetric care. The aim of this study is to determine the reliability of Symphsio-Fundal Height (SFH) measurement in assessing Gestational Age in the second half of pregnancy. Methods: A total of 390 pregnant Nigerian women carrying uncomplicated singleton pregnancies between the gestational age of 20-40 weeks had SFH measurements done at the antenatal clinic, and ultrasonic biparietal diameter (BPD) and femur length (FL) determination at the fetal assessment unit, maternity wing of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The patients were followed up subsequently and managed till delivery. At delivery each baby was examined within Results: Of the 390 patients studied, SFH correctly assessed GA in 80% compared to 81.3% for BPD (P = 0.43), 82.1% by the two methods (SFH 15-41days Vs ultrasound 15-33days). Combined ultrasound parameters(bp & FL),FL, BPD and SFH were progressively less closely correlated with the Ballard age of the fetus. Conclusions: This study showed that accurate measurement of the SFH is a reliable method of gestational age assessment in the second half of pregnancy. Keywords: Gestational age, second half of pregnancy, symphysio-fundal height INTRODUCTION been an issue of concern to obstetricians since it greatly 1 2 3 et al and Calvert et al, on the and reliable method of determining fetal age, and a useful 1 CORRESPONDENCE Dr. Munir deen A. Ijaiya, DRH, FWACS Department of Obstetrics and Gynecology University of Ilorin Teaching Hospital, Maternity wing, Ilorin, Nigeria. Phone no: +2348033801565; +2348057068400 Email: munirijaiya@yahoo.com 27
surveillance of the feto-placental unit in a well equipped The aim of this study is to determine the reliability of METHODS women who were sure of their last menstrual period, Data obtained from the subjects include age, parity, symphysio-fundal height, ultrasonic fetal biparietal et al used to measure the distance from the uterine fundus bias, measurements were made without prior knowledge the reverse side of the tape was used before turning the 11 The fetal skull was displayed at the plane of the thalamus and the septum pelucidum, and the skull outline was ensured to be oval before taking et al 12 This involved moving the transducer transversely along the fetal trunk 13 scores were used and single assessment was performed on P as the RESULTS A total of 422 28
between twenty and thirty weeks, while the remaining Figure 1 s Total No. of SFH BPD FL age (weeks) 91 91 91 91 25-29 94 94 94 94 Total 390 390 390 390 Frequency Percentage 191 Fashion Design Trading Total 390 100 Marital status Frequency Percentage Married 321 41 Divorced 13 15 Total 390 100 Frequency Percentage Primary Total 390 100 No. of Patients 180 160 140 120 100 80 60 40 20 0 160 125 37 46 10 12?19 20-24 25-29 30-34 35-39? 40 Age Group Figure 1. No.of Babies. 160 140 120 100 80 60 40 20 0 141 148 2.5-2.9 3.0-3.5 3.5-3.9 4.0-4.4 Birth Weight 79 22 29
Table 3. Comparison of symphysio-fundal height (SFH) with ultrasound biparietal diameter (BPD) and Femur Length (FL) measurements according to GA SHF BPD & FL (Weeks) Total Correct n (%) Incorrect* n (%) Total Correct n (%) Incorrect* n (%) 91 91 94 94 Table 4. Summary of comparison of symphysio-fundal height (SFH) with ultrasound biparietal diameter (BPD) and femur length (FL) measurements Method No of measurements P@ Correct n (%) Incorrect* n (%) Methods Correct (+) Incorrect (-) Total SFH 312 (true 0 (false 312 55 Total 335 55 Total 335 55 pregnancy the degree of accuracy decreases in both weeks + + r assessment correlated highly with that calculated from the r p DISCUSSION 30
13 This study showed that accurate measurement of the ultrasound is not readily available especially in our rural 14 15 et al Although menstrual age assessment is regarded as the The variability of ultrasonic parameters approaches that of deliveries in this series compares favourably with 1% et al but the incidence of 1% of preterm 2 measurement for this purpose might reduce the cost of more importantly, marked discrepancies between the REFERENCES th 31
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