Symphysis-fundal height curve in the diagnosis of fetal growth deviations

Revista de Saúde Pública

Djacyr Magna Cabral Freire²  Jose Guilherme Cecatti²  Cláudio Sergio Medeiros Paiva¹ 

[1],Universidade Estadual de Campinas Faculdade de Ciências Médicas Departamento de TocoginecologiaCampinas SP ,Brasil

关键词: Embryonic and Fetal Development;    Uterus;    Gestational Age;    Ultrasonography;    Prenatal;    Prenatal Diagnosis;    Validation Studie;    Desenvolvimento Embrionário e Fetal;    Útero;    Idade Gestacional;    Ultrassonografia Pré-Natal;    Diagnóstico Pré-Natal;    Estudos de Validação;    Desarrollo Embrionario y Fetal;    Útero;    Edad Gestacional;    Ultrasonografía Prenatal;    Diagnóstico Prenatal;    Estudios de Validación;   

DOI  :  10.1590/S0034-89102010005000044

来源: SciELO

【 摘 要 】

OBJECTIVE: To validate a new symphysis-fundal curve for screening fetal growth deviations and to compare its performance with the standard curve adopted by the Brazilian Ministry of Health. METHODS: Observational study including a total of 753 low-risk pregnant women with gestational age above 27 weeks between March to October 2006 in the city of João Pessoa, Northeastern Brazil. Symphisys-fundal was measured using a standard technique recommended by the Brazilian Ministry of Health. Estimated fetal weight assessed through ultrasound using the Brazilian fetal weight chart for gestational age was the gold standard. A subsample of 122 women with neonatal weight measurements was taken up to seven days after estimated fetal weight measurements and symphisys-fundal classification was compared with Lubchenco growth reference curve as gold standard. Sensitivity, specificity, positive and negative predictive values were calculated. The McNemar χ2 test was used for comparing sensitivity of both symphisys-fundal curves studied. RESULTS: The sensitivity of the new curve for detecting small for gestational age fetuses was 51.6% while that of the Brazilian Ministry of Health reference curve was significantly lower (12.5%). In the subsample using neonatal weight as gold standard, the sensitivity of the new reference curve was 85.7% while that of the Brazilian Ministry of Health was 42.9% for detecting small for gestational age. CONCLUSIONS: The diagnostic performance of the new curve for detecting small for gestational age fetuses was significantly higher than that of the Brazilian Ministry of Health reference curve.

【 授权许可】

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