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Self-administered symphysis-fundus measurements analyzed with a novel statistical method for detection of intrauterine growth restriction: A clinical evaluation

Artikel i vetenskaplig tidskrift
Författare Eva Bergman
Ove Axelsson
Max Petzold
Christian Sonesson
Helle Kieler
Publicerad i Acta Obstetricia et Gynecologica Scandinavica
Volym 90
Nummer/häfte 8
Sidor 890-896
ISSN 0001-6349
Publiceringsår 2011
Publicerad vid Institutionen för medicin
Sidor 890-896
Språk en
Ämnesord fetal growth, Fetal monitoring, intrauterine growth restriction, relative growth, self-administration, small for gestational age, symphysis-fundus measurement
Ämneskategorier Obstetrik och gynekologi

Sammanfattning

Objective. To assess the ability of self-administered symphysis-fundus measurements used with the Shiryaev-Roberts statistical method (SR method) to identify growth-restricted (IUGR) fetuses and compare it with the traditional SF method (symphysis-fundus measurements used with a population-based reference curve). Design. Longitudinal study. Setting. Pregnant women attending primary antenatal care centres. Population. From a population of 1 888 women with singleton ultrasound-dated pregnancies, we analyzed data from 1 122 women. Methods. Weekly self-administered SF measurements from gestational week 25 until delivery were analyzed according to the SR method. Neonatal morbidity and small for gestational age (SGA) were used as proxies for IUGR. Small for gestational age was defined as a birthweight less than two standard deviations (SD) and <10th percentile. We assessed the sensitivity of the SR and the SF methods to detect neonatal morbidity and SGA. Main Outcome Measures. Birth-related mortality, respiratory distress, hypoglycemia, Apgar score ≤6 at five minutes, pH a;circ7.00 in the umbilical artery, neonatal care, preterm delivery, operative delivery for fetal distress and SGA. Results. For the SR method, the sensitivity for neonatal morbidity was between 6.0 and 36.4%, for SGA <2SD 36.8%, and for SGA <10th percentile 20.9%. The SF method had a sensitivity between 6.0 and 13.8% for neonatal morbidity, 52.3% for SGA <2SD and 28.6% for SGA <10th percentile. Conclusions. The SR and the SF methods had low sensitivities for neonatal morbidity. © 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

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