Intrapartum symphysio-fundal height measurement as a predictor of low birth weight in a low resource setting

Abstract

Background: Low birth weight (LBW) increases the risk of perinatal morbidity and mortality and of the long term neurologic and developmental disorders. Early identification of LBW is necessary to decrease complications and enhance the survival of the newborn.

Aim: To determine the usefulness of symphysio-fundal height as a predictor of low birth weight in a low resource setting.

Methods: This was a prospective cross-sectional study of consecutive 214 parturients who presented in early labour to the Central Hospital Warri (CHW) from November 1, 2013 to February 28, 2014. Their demographic characteristics were obtained using a structured proforma. Three measurements of the symphysio-fundal height (SFH) were taken using a non-elastic tape and the mean of the three readings were calculated to the nearest centimeter. The data obtained were analyzed using statistical package SPSS version-21.

Results: Two hundred and fourteen parturients delivered during the period. The mean age and parity were 29.45±4.75years and 1.59±1.56 respectively. Twenty of the parturients (9.3%) delivered before 37weeks, 165 (77.1%) delivered at 37-40weeks while the remaining 29 parturients (13.5%) delivered at 41weeks gestation and beyond. The mean birth weight was 3184+502g. SFH measurement of 29-35 cm had a low sensitivity (3.7-37%) but a high specificity, positive and negative predictive values for low birth weight. There was a high sensitivity, specificity, positive and negative predictive values for both normal and macrosomic babies.

Conclusion: Symphysio-fundal height measurement is a simple, cheap and effective screening test to predict newborn with low birth weight.

Key words: Intrapartum, symphysio-fundal height (SFH), low birth weight, safe delivery, maternal and childhood morbidity and mortality, obstetric care