Clinical and sonographic estimation of fetal weight and correlation with the birth weight: a research article

Background: Accurate estimation of fetal weight is of paramount importance in the management of labour and childbirth. In developing countries including India, estimation of fetal weight by clinical method is important as ultrasound is not available in all health care settings. In view of this, the present study was conducted to estimate the fetal weight assessed by clinical and ultrasound method and correlating with the birth weight.Methods: A cross-sectional study was conducted to estimate fetal weight clinically by using Johnson’s formula and sonographically based on Hadlock’s formula in the Department of Obstetrics and Gynecology in collaboration with Department of Radiodiagnosis, Regional Institute of Medical Sciences, Imphal from October 2016 to March 2018. The study consisted of 525 pregnant women between 37 to 40 weeks of gestation in whom delivery was anticipated within one week of fetal weight estimation by clinical and ultrasound method and correlating it with the baby’s birth weight measured immediately after delivery. Analysis was done using Chi-square and Student’s t-test and p-value of <0.05 was taken as significant.Results: Both methods showed positive correlation with birth weight but clinical method (r=0.925) had stronger correlation compared with ultrasound method (r=0.508).Conclusions: Fetal weight estimation using Johnson’s formula had stronger correlation with the birth weight than ultrasound method and hence, useful for developing countries and all health care workers may be sensitized about the method.

A Comparison of the Accuracy of the Use of Last Menstrual Period and Symphysio-Fundal Height for Gestational Age Determination among Nigerian Women.

Aims: The aim of the study was to evaluate the accuracy of the symphysio-fundal height (SFH) in comparison to the last menstrual period (LMP) for gestational age assessment. Study Design: Hospital-based prospective cross sectional study. Place and Duration of Study: Maternity unit of the Jos University Teaching Hospital, Jos, Nigeria, between December 2012 and April 2013. Methodology: A total of 289 consecutive consenting women with singleton uncomplicated pregnancies at gestational ages of less than or equal to 20 weeks were recruited at the maternity unit of Jos University Teaching Hospital between December 2012 and April 2013. Ultrasound scan (USS) was used to confirm eligibility after which other information including the LMP were documented on a questionnaire. The women returned after 22 weeks’ gestation based on ultrasound recorded GA for SFH assessment and some weeks thereafter for a second SFH assessment. Results: Mean age of the women was 28.9±4.8 years with a range of 16-42 years. Most of them were of parity 1 – 4 (58.1%). The mean GA at booking was 15.3±3.1 weeks based on LMP and 14.9±3.1 from early ultrasound scan. The mean percentage accuracy for SFH method compared to USS dating was 95.8% while that of LMP was 91.0%. This difference was found to be statistically significant (P = .02). Conclusion: The study showed a significant difference between the LMP and early ultrasound scan dating but not between SFH and early ultrasound scan. Also, the mean percentage accuracy was statistically higher for SFH, suggesting that SFH was a more accurate tool for gestational age assessment among these women.

Symphysio Fundal Height (SFH) Measurement as a Predictor of Birth Weight.

Fetal weight is a very important factor to make a decision about labor and delivery. Assuming that in large fetuses, dystocia and other complications like cerebral edema, neurological damage, hypoxia and asphyxia may result during or after the delivery. On the other hand, one of the causes of high perinatal mortality in our country is high rate of low birth weight. Rural people may not have access to ultrasonography which is one of the methods to predict birth weight. For these people alternative easy method is necessary. So we can assess fetal birth weight by measuring symphysio-fundal height. Total 100 consecutive pregnant women of gestational age more than 32 weeks admitted for delivery in the Obstetric and Gynaecology department of Faridpur General Hospital were the subject of this study. After selection of cases, a thorough clinical history was taken and elaborate physical examination was done. Common criteria for collection of data were followed in every case. The fetal weight estimated by Johnson's formula was recorded in the predesigned data sheet and then was compared with birth weight following delivery of the fetus. Collected data were compiled and relevant statistical calculations were done using computer based software. Statistical tests (Correlation) were done between actual birth weight (taken as dependant variable) and fetal weight (found by Johnson's Formula), symphysio fundal height (SFH), pre-delivery weight and height of the patients (taken as independent variables) and the tests revealed that actual birth weight was significantly correlated with fetal weight (found by Johnson's Formula), SFH, pre-delivery weight and height of the patients. Among these fetal weight and SFH had shown highest correlation. Regression analysis showed that SFH, maternal height and maternal weight explained respectively 59%, .011% and .009% of observed variation of birth weight.