OnExam
Symphysis-Fundal Height
This test is used to track fetal growth and screen for abnormalities.
Performing the Test
Begin by ensuring the woman's bladder is adequately empty as this may alter the measurement
Use a flexible measuring tape
Measure from the top of the symphysis pubis, over the pregnant abdomen, to the top of the uterine fundus, as determined by palpation
Interpretation
When expressed in centimetres (cm), corresponds roughly with the gestational age (GA) expressed in weeks
If the difference between SFH and GA is greater than 2.0 cm, it could be indicative of an abnormality
SHF greater than expected can be due to multiple gestation, macrosomia, and polyhydramnios
SHF less than expected can be indicative of growth retardation but can also occur if the fetus is in a transverse lie
As a screening tool for fetal growth abnormalities:
Sensitivity of 16.6% for detecting large for gestational age (LGA) neonates
Sensitivity of 17.3% for detecting small for gestational age (SGA) neonates
Specificity of 92.4-95.4%
References
Bickley LS. Bates’ Guide to Physical Examination and History Taking. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23rd ed. New York: McGraw-Hill; 2010.
Sparks TN, et al. Fundal height: a useful screening tool for fetal growth? [published online ahead of print September 17, 2010]. J Matern Fetal Neonatal Med. http://informahealthcare.com/doi/abs/10.3109/14767058.2010.516285