Mean symphysis - fundal height and abdominal circumference measurement at the level of umbilicus in primigravida at 30 -34 weeks of gestation in nepalese women.

Thesis Report.

ABSTRACT: This study was conducted in Maternity Hospital, Thapathali, Kathmandu from 2057/08/08 to 2058/01/20 (23rd Nov. 2001 to 3rd May 2001). There are between 60-100 new registered cases in antenatal clinic everyday. The overall objective of this study was to find out the mean symphysis- fundal height (SFH) and abdominal circumference (AC) in primigravida at 30-34 wks of gestation and the correlation between the two. It is also to evaluate the fetal outcome (birth weight)in the first rolled women in relation to the first measured SFH and AC (at 32-33 weeks). Aprospective hospital based descriptive study was carried out in 650 pregnant women at 30-34 weeks of gestation who had attended for the antenatal check up in the maternity hospital. The women with singleton pregnancy, with longitudinal lie and cephalic presentation without any complications were enrolled for the study. Study cases were divided in 30-31 week group (n=268), 32-33 week group (n=250) and 34 week group (n=132) according to gestational period. The SFH was measured in supine position from upper border of symphysis pubis to highest point of uterine fundus after evacuation of bladder and AC at the level of umbilicus. The height and weight of the women were measured and their relation with SFH and AC at 32-33 weeks was also analyzed. Similarly, the relation of fetal outcome in terms of birth weight with SFH and AC was also analyzed in 100 cases of the women from this group. Results The mean SFH and AC at 30-31 weeks of gestation were 28.38 cms and 84.35 cms with S.D. 2.17 and 4.93cms respectively. At 32-33 weeks of gestation mean SFH was 30.04 cms with S.D.2.10 cms and AC 85.66cms with S.D.5.45 cms. Similarly, at 34 weeks the mean SFH and AC were 31.44 cms. respectively. There was significant and sequential increase of SFH and AC from 30-31 weeks to 32-33 weeks then to 34 weeks. (P=<0.01). There was a positive correlation of AC with SFH in all groups which was statistically significant (P=<0.01). The relation of height and weight with SFH and AC was studied in women at 32-33 weeks of gestation (n=250). There was a positive correlation of SFH and AC with height (P=<0.01). Similarly, the relation of weight with SFH and AC was also statistically significant (P<0.01). The mean birth weight in the group first measured SFH and AC at 32-33 weeks was 2904 gms. The relation of birth weight with SFH and AC in this group (n=100) was analyzed. This was also statically significant (P<0.003 and 0.0001 respectively). Conclusion There was a significant positive correlation of AC with SFH. The relation of SPH and AC with height and weight of the mother was also statistically significant. There was a significant relation of first measured SFH and AC with birth weight. With measurements below the mean value for SFH and AC that gestational age, the mothers delivered small babies. The measurement of abdominal circumference at umbilical level is easier then the measurement of symphysis-fundal height.

Eng.