Diagnostic Accuracy of Symphysio-Fundal Height in Detection of FGR by Taking Ultrasound as a Standard

Abstract

Objectives: To measure the diagnostic accuracy of symphysio-fundal height in detection of fetal growth restriction by taking ultrasound as a gold standard.

Study Design: validation study

Settings: Department of Obstetrics and Gynaecology, BBH, Rawalpindi.

Study Duration: 5th April 2022 to 4th October 2022.

Materials & Methods: A total of 225 women with singleton pregnancies between 28 and 36 weeks of gestation, aged 18 to 40, were enrolled. We excluded patients with fetal cardiac activity, congenital abnormalities, and polyhydroamnios. A researcher measured the fundal height every two weeks between weeks 28 and 38 at prenatal clinic visits. The distance between the uterine fundus and the top of the symphysis pubis was measured using a non-stretchable tape that came into touch with the skin of the abdominal wall. The researcher was facing the inch side of the tape to avoid bias. The inspecting hand's palm applied light pressure at a straight angle to the abdomen wall to delineate the fundus. Plotting of the measurements onto the normogram was done after they were measured in centimeters (to the nearest 0.5 cm). A radiologist performed an ultrasound to confirm FGR if it did not match gestational age.

Results: Overall sensitivity, specificity, PPV, NPV and diagnostic accuracy of symphysio-fundal height in detection of fetal growth restriction by taking ultrasound as a gold standard was 92.08%, 88.37%, 92.76%, 87.36% and 90.67% respectively. Conclusion: This study concluded that symphysio-fundal height is a highly sensitive and accurate parameter for detecting fetal growth restriction.