SynthesisPloS one2022
Measurement of symphysis fundal height for gestational age estimation in low-to-middle-income countries: A systematic review and meta-analysis.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Factors influencing the competence of student midwives in symphysis-fundal height measurement: A quantitative study.Curationis · 2026Article
- A retrospective review of screening for HIV, syphilis and anaemia on first antenatal care visits at a midwife-run obstetric unit in South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- In Primiparous Women at Term, a Symphysial Fundal Height of 36 cm Is Linked to the Lowest Risk of Emergency Caesarean Section and Postpartum Haemorrhage.The Australian & New Zealand journal of obstetrics & gynaecology · 2026Article
- Associations with the inter-recti distance at gestation week 37: a prospective cohort study among healthy pregnant women.BMC pregnancy and childbirth · 2025Article
- Comparison of Gestational Age Assessment Methods in the Second and Third Trimesters: Evaluating Alternative Approaches Against Ultrasound in Urban Burkina Faso.Journal of clinical medicine · 2025Article
- Lecturers' perceptions on student midwives' competence in symphysis fundal height measurement.Health SA = SA Gesondheid · 2025Article
- Relationship between Placental Thickness and Gestational Age and Development of Novel Normative Percentile Charts and Table of Placental Thickness During Pregnancy: A Systematic Review.Journal of medical ultrasoundReview
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
In low- and middle-income countries (LMIC), measurement of symphysis fundal height (SFH) is often the only available method of estimating gestational age (GA) in pregnancy. This systematic review aims to summarize methods of SFH measurement and assess the accuracy of SFH for the purpose of GA estimation. We searched PubMed, EMBASE, Cochrane, Web of Science, POPLINE, and WHO Global Health Libraries from January 1980 through November 2021. For SFH accuracy, we pooled the variance of the mean difference between GA confirmed by ultrasound versus SFH. Of 1,003 studies identified, 37 studies were included. Nineteen different SFH measurement techniques and 13 SFH-to-GA conversion methods were identified. In pooled analysis of five studies (n = 5838 pregnancies), 71% (95% CI: 66-77%) of pregnancies dated by SFH were within ±14 days of ultrasound confirmed dating. Using the 1 cm SFH = 1wk assumption, SFH underestimated GA compared with ultrasound-confirmed GA (mean bias: -14.0 days) with poor accuracy (95% limits of agreement [LOA]: ±42.8 days; n = 3 studies, 2447 pregnancies). Statistical modeling of three serial SFH measurements performed better, but accuracy was still poor (95% LOA ±33 days; n = 4 studies, 4391 pregnancies). In conclusion, there is wide variation in SFH measurement and SFH-to-GA conversion techniques. SFH is inaccurate for estimating GA and should not be used for GA dating. Increasing access to quality ultrasonography early in pregnancy should be prioritized to improve gestational age assessment in LMIC.
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Registered trials
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