Dating gestational age by last menstrual period, symphysis-fundal height, and ultrasound in urban Pakistan
Objective: To compare the accuracy of the reported date of the last menstrual period (LMP) with that of symphysis-fundal height (SFH) in the estimation of gestational age (GA), using an ultrasound (US) scan as reference. Methods: Gestational age was concurrently assessed by the 3 methods in this prospective, population-based, pregnancy-outcome study conducted in Hyderabad, Pakistan, from June 18. 2003, through August 31, 2005, with 1128 women between 20 and 26 weeks of a singleton pregnancy. Results: The mean GA was less by ultrasound than by SFH measurement or the reported LMP, and the mean differences with the US result were statistically significant (P<0.001 for both). At delivery, about 75% of the GA values estimated by SFH measurement were within 7 days and almost 91% were within 14 days of the estimation by ultrasound, compared with 65% and 82% for the GA estimated by the reported LMP. Moreover, using the US as reference, the SFH correctly classified 84% of the term, 68% of the preterm, and 86% of the post-term deliveries (weighted kappa=0.58) compared with the corresponding 79%, 61%, and 55% predicted by the reported LMP (Weighted kappa=0.44). Conclusion: The SFH measurement was found to be more accurate than the reported LMP as a tool to estimate GA and therefore date of delivery, but neither were as accurate as a US scan. (C) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved
Jehan, I., Zaidi, S., Rizvi, S., Mobeen, N., McClure, E., Munoz, B., ... Goldenberg, RL. (2010). Dating gestational age by last menstrual period, symphysis-fundal height, and ultrasound in urban Pakistan. International Journal of Gynecology & Obstetrics, 110(3), 231-234.