title: Diagnostic accuracy of fundal height and handheld ultrasound-measured abdominal circumference to screen for fetal growth abnormalities.
abstract: OBJECTIVE
  We sought to compare fundal height and handheld ultrasound-measured fetal abdominal circumference (HHAC) for the prediction of fetal growth restriction (FGR) or large for gestational age.
  
  
  METHODS
  This was a diagnostic accuracy study in nonanomalous singleton pregnancies between 24 and 40 weeks' gestation. Patients underwent HHAC and fundal height measurement prior to formal growth ultrasound. FGR was defined as estimated fetal weight less than 10%, whereas large for gestational age was defined as estimated fetal weight greater than 90%. Sensitivity and specificity were calculated and compared using methods described elsewhere.
  
  
  RESULTS
  There were 251 patients included in this study. HHAC had superior sensitivity and specificity for the detection of FGR (sensitivity, 100% vs 42.86%) and (specificity, 92.62% vs 85.24%). HHAC had higher specificity but lower sensitivity when screening for LGA (specificity, 85.66% vs 66.39%) and (sensitivity, 57.14% vs 71.43%).
  
  
  CONCLUSIONS
  HHAC could prove to be a valuable screening tool in the detection of FGR. Further studies are needed in a larger population.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC. Electronic address: haragan@musc.edu.
authors.forename: Adriane F
authors.initials: AF
authors.lastname: Haragan
authors.affiliation: West Virginia University School of Public Health, Morgantown, WV.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Hulsey
authors.affiliation: Maternal-Fetal Medicine, Regional Obstetrical Consultants, Chattanooga, TN.
authors.forename: Angela F
authors.initials: AF
authors.lastname: Hawk
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Newman
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC.
authors.forename: Eugene Y
authors.initials: EY
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005333:Fetus / Q000648:ultrastructure*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods; D014599:Uterus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: fetal growth abnormalities; fundal height; ultrasound
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