Symphysio-fundal height measurement as a tool in antenatal care: current understanding: narrative review

Abstract

Symphysio-fundal height (SFH) measurement during pregnancy was recognized as a simple clinical indicator for monitoring fetal growth since decades. However, its significance and validity are questioned in recent era of Sonography. This is a narrative review of the topic published. Conclusions of systematic reviews, meta-analysis as well as studies which compared SFH and ultrasound for fetal growth monitoring were included. The review revealed SFH has poor sensitivity as a tool for screening and diagnosing fetal growth restriction and inter-observer variations are high and hence fallacious. However multiple measurement model incorporating standard international guidelines may be useful in resource poor settings. Limitations of SFH include that it is not useful in hydramnios, multiple pregnancies and pregnancies with uterine or ovarian masses and fetuses in transverse lie. For screening and early diagnosis of growth restriction, estimation of gestational age and fetal weight estimation USG is the standard tool.