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Symphysial fundal height (SFH) measurement in pregnancy for detecting abnormal fetal growth

  • Review
  • Intervention




Symphysis fundal height (SFH) measurement is commonly practiced primarily to detect fetal intrauterine growth restriction (IUGR). Undiagnosed IUGR may lead to fetal death as well as increase perinatal mortality and morbidity.


The objective of this review is to compare SFH measurement with serial ultrasound measurement of fetal parameters or clinical palpation to detect abnormal fetal growth (IUGR and large-for-gestational age), and improving perinatal outcome.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (20 January 2012) and reference lists of retrieved articles.

Selection criteria

Randomised controlled trials including quasi-randomised and cluster-randomised trials involving pregnant women with singleton fetuses at 20 weeks' gestation and above comparing tape measurement of SFH with serial ultrasound measurement of fetal parameters or clinical palpation using anatomical landmarks.

Data collection and analysis

Two review authors independently assessed trials for inclusion, trial quality and extracted data. Data were checked for accuracy.

Main results

One trial involving 1639 women was included. It compared SFH measurement with clinical abdominal palpation.

There was no difference in the two reported primary outcomes of incidence of small-for-gestational age (risk ratio (RR) 1.32; 95% confidence interval (CI) 0.92 to 1.90) or perinatal death. There was no difference in the reported secondary outcomes of neonatal hypoglycaemia, admission to neonatal nursery, admission to the neonatal nursery for IUGR, induction of labour and caesarean section.

Authors' conclusions

There is insufficient evidence to determine whether SFH measurement is effective in detecting IUGR. We cannot therefore recommended any change of current practice. Further trials are needed.








Cochrane Pregnancy and Childbirth Group's Trials Register(2012年1月20日)および収集した論文の文献リストを検索した。






1,639名の女性を対象とした1件の試験を選択した。SFH計測を臨床的腹部触診と比較していた。 報告された2つの主要アウトカム、在胎期間に比して小さい児の発現率[リスク比(RR)1.32、95%信頼区間(CI)0.92~1.90]および周産期死亡に差はみられなかった。報告された副次アウトカム、新生児低血糖、新生児室入院、IUGRとしての新生児室入院、分娩誘発、帝王切開に差はみられなかった。



Plain language summary

Measuring the height of the uterus from the symphysis pubis (SFH) in pregnancy for detecting problems with fetal growth

Monitoring the baby’s growth is important during pregnancy. If growth is poor then this should be identified as soon as possible, because delay might result in the baby’s death. The simplest way to determine growth is to examine the mother by abdominal palpation and estimate the size of her womb compared with a landmark such as the navel (umbilicus). An alternative method is to use a tape measure to take a measurement, known as the symphysial fundal height (SFH) measurement, from the mother’s pubic bone (symphysis pubis) to the top of the womb. The measurement is then applied to the gestation by a simple rule of thumb and compared with normal growth. It is not known which of these two methods is more likely to detect poor growth. Ultrasound assessment can also be used to detect growth restriction but this is costly and not always available, and there are concerns about its unnecessary use. This review found only one randomised trial (involving 1639 women at 20 weeks’ gestation and above) comparing repeated measures of SFH with abdominal palpation. The trial found no difference between the two approaches in detecting poor growth. With such limited evidence it is still not known whether one method is more effective than the other, and how these methods compare with ultrasound measurement. We therefore do not recommend any change in current practice.





監  訳: 江藤 宏美,2012.11.14

実施組織: 厚生労働省委託事業によりMindsが実施した。

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