OBJECTIVES: Evaluation of symphysis fundus measurements in a large ant
enatal clinic. METHODS: The obstetrical records were reviewed for all
patients that had delivered over a 3-month period. From this group of
1455, a sample of 386 was taken that had a singleton pregnancy, had bo
oked before 24 weeks' gestation and had attended the antenatal clinic
at least twice. The study group comprised 65 patients with less than e
xpected symphysis fundus growth and a control group of 249 in whom gro
wth seemed adequate. The remaining 72 subjects' files were either inco
mplete or the interobserver variation of the symphysis fundus measurem
ents at the end of pregnancy seemed too high. RESULTS: Deficient intra
-uterine growth, as shown by the symphysis fundus measurements, was si
gnificantly associated with both low birthweight (< 2500 g) (odds rati
o 3.02) and intra-uterine growth retardation (IUGR) (odds ratio 3.43),
but no association was found with perinatal mortality. The sensitivit
y for detecting IUGR was 42%. CONCLUSIONS: Symphysis fundus measuremen
ts, as made in our antenatal clinic, seem of limited value. We propose
that the number of observers be restricted in order to decrease the i
nterobserver variation.