Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/94899
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dc.contributor.authorRoex, A.en
dc.contributor.authorNikpoor, P.en
dc.contributor.authorvan Eerd, E.en
dc.contributor.authorHodyl, N.en
dc.contributor.authorDekker, G.en
dc.date.issued2012en
dc.identifier.citationObstetrical & Gynecological Survey, 2012; 67(6):331-332en
dc.identifier.issn0029-7828en
dc.identifier.urihttp://hdl.handle.net/2440/94899-
dc.description.abstractEarly detection of a small-for-gestational-age fetus (SGA) can potentially lower the risk of stillbirth, neonatal death, and other adverse outcomes. After identification of an SGA fetus, appropriate intervention can reduce the likelihood of perinatal morbidity, including fetal compromise during labor and cerebral palsy in childhood. The traditional guideline for SGA detection used in most obstetric units in Australia is that fundal height (FH) should be equal to gestational age. More than 10 years ago, a nonrandomized quasi-controlled study conducted in a primary health care setting reported that the use of serial plotting of the FH on customized charts increased the likelihood of detecting SGA nearly 2-fold compared with the traditional method. However, other studies have not confirmed these findings. This observational study investigated whether the introduction of serial plotting of the FH on customized charts at a teaching hospital in Australia would increase the antenatal detection rate of SGA among low-risk singleton nulliparous women when combined with a clinical practice guideline and regular audits. The SGA detection rate was compared with that of a historical control group comprising first-time mothers who had received traditional antenatal care and had delivered before this change in practice. In the intervention group, serial FH plotting on customized charts was used, together with a clinical practice guideline and regular audits to promote clinician adherence to the protocol. In the control group, FH was measured and documented during every antenatal visit, but no SGA guideline, serial plotting, or regular audits were used. Use of serial plotting nearly doubled the antenatal detection rate of SGA compared with the traditional approach for detection (intervention group: 50.6% 44⁄87 vs. control group: 24.8% 31⁄125); the odds ratio was 3.10, with a 95% confidence interval of 1.73 to 5.57 and P 0.001. These findings suggest that more clinicians should use serial FH plotting on a customized chart for primary screening and detection of SGA in nulliparous pregnant women at low risk for SGA rather than the traditional approach.en
dc.description.statementofresponsibilityAlphonse Roex, Payam Nikpoor, Eva van Eerd, Nicolette Hodyl, and Gus Dekkeren
dc.language.isoenen
dc.publisherLippincott, Williams & Wilkinsen
dc.rights© 2012 Lippincott Williams & Wilkins, Inc.en
dc.titleSerial plotting on customized fundal height charts results in doubling of the antenatal detection of small-for-gestational-age fetuses in nulliparous womenen
dc.typeJournal articleen
dc.identifier.rmid0030029952en
dc.identifier.doi10.1097/OGX.0b013e31825bbb45en
dc.identifier.pubid115610-
pubs.library.collectionMedicine publicationsen
pubs.library.teamDS02en
pubs.verification-statusVerifieden
pubs.publication-statusPublisheden
dc.identifier.orcidHodyl, N. [0000-0003-2025-5310]en
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