Estimation of gestational age from fundal height

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

Lisa J. White^1,2, Sue J Lee^1,2, Kasia Stepniewska^1,2, Julie A. Simpson^2,3, Saw Lu Mu Dwell⁴, Ratree Arunjerdja⁴, Pratap Singhasivanon², Nicholas J. White^1,2, Francois Nosten^1,2,4, Rose McGready^1,2,4

¹Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK

²Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

³Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Melbourne, Australia.

⁴Shoklo Malaria Research Unit, PO Box 46 Mae Sot, Tak, Thailand, 63110

Summary

Many women in resource poor settings lack access to reliable gestational age assessment because they do not know their last menstrual period (LMP), there is no ultrasound and methods of newborn gestational age dating are not practiced by birth attendants. A bespoke multiple-measures model was developed to predict the expected date of delivery (EDD) determined by ultrasound.   Prospectively collected early ultrasound and serial symphysis-pubis fundal height (SFH) data were used in the model. The data were collected from Karen and Burmese women attending antenatal care on the Thai-Burmese border. SFH remains the proxy for gestational age in much of the resource poor world. While more accurate measures should be encouraged we provide a formula that incorporates at least three SFH measures from an individual mother and the slopes between them provides a significant increase in the accuracy of prediction compared with linear and non-linear formulae also using multiple SFH measures.

Click here to download an excel file that will apply the model to SFH measures.

Click here to download more detailed information about this model.