Use of fundal height as a proxy for length of gestation in rural Africa.

Lack of information on the date of the last menstrual period is a common problem in antenatal care in developing countries. The aim of this study was to see whether the fundal height can be used as a proxy for the length of gestation. A graph representing the expected remaining time to delivery was constructed from fundal height measurements in 7790 pregnant women delivered in a rural African hospital from 1970 to 1988. The graph was used to predict the probable week of delivery in 604 pregnant women giving birth to a singleton child in 1989. The mean deviation of the actual week of delivery from the predicted week was -0.6 (s.d. 3.4) weeks. In 270/604 cases (45%) delivery occurred within 2 weeks of the predicted week. Birthweight and perinatal mortality were strongly related to the deviation from the predicted week of delivery. The majority of perinatal deaths (34/50, 68%) occurred in children delivered early. The fundal height, as measured by paramedicals in routine antenatal care in rural Africa, may be used as a proxy for the length of gestation when the date of the last menstrual period is not known.