Use of fundal height as a proxy for length of gestation in rural Africa
Andersson, R.; Bergström, S.
Journal of Tropical Medicine and Hygiene 98(3): 169-172
1995
ISSN/ISBN: 0022-5304 PMID: 7783274 Document Number: 446391
The length of gestation is an important determinant of birthweight and perinatal death. In developing countries, however, it is often difficult to obtain reliable information on the date of the last menstrual period. Local calendars have been used successfully, but that approach is not possible in some cultures, while ultrasound remains too expensive to be used routinely in such developing country settings. On the basis of fundal height measurements for 7790 pregnant women who delivered at the Centre Medical of Gamboula, Central African Republic, over the period 1970-1988, the authors constructed a graph representing the expected remaining time to delivery in their study of whether fundal height can be used as a proxy for length of gestation. The graph was used to predict the probable week of delivery in 604 pregnant women giving birth to a singleton child in 1989; the mean deviation of the actual week of delivery from the predicted week was -0.6 weeks. In 270/604 cases, delivery occurred within two weeks of the predicted week. Birthweight and perinatal mortality were strongly related to the deviation from the predicted week of delivery. 34 of 50 perinatal deaths occurred in children delivered early. It may therefore be concluded on the basis of these findings that fundal height, as measured by paramedicals in routine antenatal care in rural Africa, may be used as a proxy for the length of gestation when the date of the last menstrual period is not known.