A simple clinical formula for predicting fetal weight in labour at term: derivation and validation
To derive and validate a simple formula for birth weight based on symphysis-fundal height (SFH) measurement during labour, and to determine a useful SFH cut-off value for prediction of birth weight ≥4000 g.
In a derivation study, SFH was measured on women at term in the active phase of labour. A simplified formula for birth weight was derived from a regression equation. The best cut-off SFH measurement was obtained for prediction of birth weight ≥4000 g. Following this, a similar study was done to validate these findings.
In the derivation study (n=504), birth weight was predicted by the equation: birth weight in g = 301+78 (SFH in cm). This was transformed to the simplified formula: birth weight in g = 100 ([SFH in cm] – 5). Using this formula for the data set, 68.1% of birth weight estimates were correct to within 10% of the birth weight. For prediction of birth weight ≥4000 g, an SFH measurement of 40 cm had a sensitivity of 82%, and a specificity of 80%. In the validation study (n=294), the derived simplified formula gave 65.0% of estimates correct to within 10% of the birth weight. The predictive values of the 40 cm SFH cut-off were similar to those in the derivation study.
The derived simplified formula was validated in the second study. The formula may be useful for intrapartum use in term pregnancies. A cut-off SFH measurement of 40 cm may identify labours at risk for cephalopelvic disproportion or shoulder dystocia.
Eckhart Buchmann, Department of Obstetrics and Gynaecology, University of the Witwatersrand
Karabo Tlale, Department of Obstetrics and Gynaecology, University of the Witwatersrand
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Date published: 2009-06-12
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