Bergman Eva, Kieler Helle, Petzold Max, Sonesson Christian, Axelsson Ove
Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Uppsala, Sweden.
Acta Obstet Gynecol Scand. 2007;86(6):671-7. doi: 10.1080/00016340701258867.
Antenatal identification of infants small for gestational age (SGA) improves their perinatal outcome. Repeated measurement of symphysis-fundus (SF) heights performed by midwives is the most widespread screening method for detection of SGA. However, the inefficiency of this method necessitates improved practices. Earlier start and more frequent SF measurements, which could be accomplished by self-administered measurements, might improve the ability to detect deviant growth. The present study was set up to evaluate whether pregnant women can reliably perform SF measurements by themselves.
Forty healthy women with singleton and ultrasound-dated pregnancies from 2 antenatal clinics in Uppsala, Sweden, were asked to perform 4 consecutive SF measurements once every week, from 20 to 25 weeks of gestation until delivery. The self-administered SF measurements were recorded and systematically compared with midwives' SF measurements.
Thirty-three pregnant women performed self-administered SF measurements over a 14-week period (range: 1-21). The SF curves constructed from self-administered SF measurements had the same shape as previously constructed population-based reference curves. The variance for self-administered SF measurements was higher than that of the midwives.
Pregnant women are capable of measuring SF heights by themselves, but with higher individual variance than midwives. Repeated measurements at each occasion can compensate for the higher variance. The main advantage of self-administered SF measurements is the opportunity to follow fetal growth earlier and more frequently.
产前识别小于胎龄儿（SGA）可改善其围产期结局。由助产士重复测量耻骨联合上缘（SF）高度是检测SGA最广泛使用的筛查方法。然而，该方法效率低下，需要改进。更早开始并更频繁地测量SF，这可以通过自我测量来实现，可能会提高检测异常生长的能力。本研究旨在评估孕妇是否能够可靠地自行测量SF。
从瑞典乌普萨拉的2家产前诊所选取40名单胎且经超声确定孕周的健康孕妇，要求她们在妊娠20至25周直至分娩期间，每周进行1次，连续进行4次SF测量。记录自我测量的SF数据，并与助产士测量的SF数据进行系统比较。
33名孕妇在14周内（范围：1 - 21周）进行了自我SF测量。由自我测量构建的SF曲线与先前构建的基于人群的参考曲线形状相同。自我测量的SF数据方差高于助产士测量的。
孕妇能够自行测量SF高度，但个体方差高于助产士。每次进行重复测量可弥补较高的方差。自我测量SF的主要优点是有机会更早、更频繁地监测胎儿生长。
