title: Self-administered symphysis-fundus measurements analyzed with a novel statistical method for detection of intrauterine growth restriction: a clinical evaluation.
abstract: OBJECTIVE
  To assess the ability of self-administered symphysis-fundus measurements used with the Shiryaev-Roberts statistical method (SR method) to identify growth-restricted (IUGR) fetuses and compare it with the traditional SF method (symphysis-fundus measurements used with a population-based reference curve).
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Pregnant women attending primary antenatal care centres.
  
  
  METHODS
  From a population of 1 888 women with singleton ultrasound-dated pregnancies, we analyzed data from 1 122 women.
  
  
  METHODS
  Weekly self-administered SF measurements from gestational week 25 until delivery were analyzed according to the SR method. Neonatal morbidity and small for gestational age (SGA) were used as proxies for IUGR. Small for gestational age was defined as a birthweight less than two standard deviations (SD) and <10th percentile. We assessed the sensitivity of the SR and the SF methods to detect neonatal morbidity and SGA.
  
  
  METHODS
  Birth-related mortality, respiratory distress, hypoglycemia, Apgar score ≤6 at five minutes, pH ≤7.00 in the umbilical artery, neonatal care, preterm delivery, operative delivery for fetal distress and SGA. Results. For the SR method, the sensitivity for neonatal morbidity was between 6.0 and 36.4%, for SGA <2SD 36.8%, and for SGA <10th percentile 20.9%. The SF method had a sensitivity between 6.0 and 13.8% for neonatal morbidity, 52.3% for SGA <2SD and 28.6% for SGA <10th percentile.
  
  
  CONCLUSIONS
  The SR and the SF methods had low sensitivities for neonatal morbidity.
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Sweden. eva.bergman@kbh.uu.se
authors.forename: Eva
authors.initials: E
authors.lastname: Bergman
authors.forename: Ove
authors.initials: O
authors.lastname: Axelsson
authors.forename: Max
authors.initials: M
authors.lastname: Petzold
authors.forename: Christian
authors.initials: C
authors.lastname: Sonesson
authors.forename: Helle
authors.initials: H
authors.lastname: Kieler
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D005748:Gastric Fundus / Q000033:anatomy & histology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011631:Pubic Symphysis / Q000033:anatomy & histology*; D012680:Sensitivity and Specificity; D014599:Uterus / Q000033:anatomy & histology*