Estimation of fetal weight by external abdominal measurements and fundal height measurement near term for the detection of intra-uterine growth retardation

Objectives. - To evaluate the estimation of fetal weight by external abdominal measurements, alone or associated with fundal height measurement and/or ultrasonographic exams near 32 weeks, to detect intra-uterine growth retardation (IUGR) near term. Patients and methods. - A retrospective cohort study included all women who delivered a small-for-gestational-age infant less than 37 weeks gestation during 2008-2009. We analyzed the sensitivity of estimation of fetal weight by external abdominal measurements and the others different routine exams during third trimester, and compared them to detect IUGR near term. Results. - The estimation of fetal weight by external abdominal measurements was used in 263 pregnant patients. External abdominal measurements and fundal height measurement were not statistically different and were better tests than ultrasonographic exams at 32 weeks to detect IUGR near term (sensitivity: 41.4%, 42.2% and 22.8%, respectively; P < 0.05). External abdominal measurements associated with regular ultrasonographic examination at 32 weeks of gestation significantly increased the sensitivity to detect IUGR near term (42.9% vs 22.8%; P < 0.05). But, the association of external abdominal measurements and fundal height measurement did not increase the rate of detection (47.9% vs 42.2%; P = 0.22). Discussion and conclusion. - The present findings confirm that the use of the estimation of fetal weight by external abdominal measurements to detect intra-uterine growth retardation is effective. Measures to improve the learning of this technique and its reproducibility are recommended. (C) 2012 Elsevier Masson SAS. All rights reserved.