Use Of Fundal Height Curve In Prenatal Care
Keywords:
fundal height, prenatal care, fetal growth, gestational ageAbstract
The objective of this review is to highlight the importance of measuring fundal height in prenatal care. It contextualizes prenatal care in relation to the reduction of perinatal morbidity and mortality and in relation to the prevention of fetal growth restriction. It historically rescues the use of measuring uterine height, in a period that goes from the 18th century to the 20th century. It demonstrates, for primary care sectors for pregnant women, the value of measuring fundal height and the use of the fundal height curve by gestational age, to identify fetuses at risk of having low birth weight. It describes the conclusions of several studies, in different countries, valuing the use of uterine height curves, and alerting to the need to standardize the technique for measuring uterine height, as well as the use of reference standards suitable for each population, to obtain of better results. It also discusses the technical and methodological aspects of the curve standardized by the Ministry of Health, warning of the possible limitations of using fundal height curves constructed with data from ethnically distinct populations. In conclusion, it highlights the recommendation of the studies cited, to construct fundal height curves by gestational age, based on data from population groups that are more homogeneous in relation to the target population.
Downloads
References
Romito P, Hovaleque F. Changing approaches in women's health: new insights and new pitfalls in prenatal preventive care. lnt J Health Serv 1987; 17(4):241-58.
Armstrong S, Royston E, editors. Preventing maternal deaths. Geneva: World Health Organization; 1989.
Silveira DS, Santos IS, Costa JSD. Atenção pré-natal na rede básica: uma avaliação da estrutura e do processo. Cad Saude Publica 2001; 17(1):131-9.
Brasil. Ministério da Saúde. Urgências e emergências maternas: guia para diagnóstico e conduta em situações de risco de morte materna. 2.ed. Brasília; 2000. 119p.
Laurenti R, Buchalla CM. Estudo da morbidade e mortalidade perinatal em maternidades: li - Mortalidade perinatal segundo o peso ao nascer, idade materna, assistência pré-natal e hábito de fumar da mãe. Rev Saude Publica 1985; 19(3):225-32
Barros EC, Victora CJ, Vaughan JP. Mortalidade perinatal e infantil em Pelotas-RS, Brasil: utilização de uma classificação simplificada. Rev Saude Publica 1987; 21 (6) 310-6.
Kogan MD, Alexander GR, Kotelchuck M, Nagey DA, Jack BW Comparing mothers' reports on the content of prenatal care received with recommend national guidelines for care. Publ Health Rep 1994; 109(7):637-46.
Rouquayrol MZ, Correia LL, Barbosa LMM, Xavier LGM, Oliveira J, Fonseca W Fatores de risco de natimortalidade em Fortaleza: um estudo de casocontrole. J Pediatr 1996; 72(4):374-8.
Giron SG, Marktevicz W, Novaes MA, Schor N, Ciari Jr C, Siqueira AAF. A importância do diagnóstico em nível local para o planejamento de serviço de saúde materna. Rev Saude Publica 1974; 8(1):43-9.
Sancovski M. Consulta pré-natal. ln: Zugaib M, Sancovski M. O pré-natal. São Paulo: Atheneu; 1 991 . p .11-7.
Cunha SP, Oliveira APN, Mendes MC. A enfermagem, o obstetra e a obstetrícia. J Febrasgo 2002; 9(1 ):3-10
Brasil. Ministério da Saúde. Assistência pré-natal. 3. ed. Brasília; 2000. 65p.
Centro Latino-Americano de Perinatologia. Saúde Perinatal: artigos selecionados. Montevidéu: CLAP, 1988. (Boletim do CLAP).
Tanaka ACDA. Saúde materna e perinatal: relações entre variáveis orgânicas, socioeconômicas e institucionais [tese]. São Paulo: Faculdade de Saúde Pública, Universidade de São Paulo, 1986.
Aquino MM, Cecatti JG, Mariani Neto C. Risk factors associated to fetal death. Rev Paul Med 1998; 116(6): 1852-7.
Montenegro CA, Rezende Filho J. Gestação de alto risco. ln: Rezende J. Obstetrícia. 9.ed. Rio de Janeiro: Guanabara Koogan; 2002. p.968-87.
Villar J, Belizan JM. The evolution of the methods used in the diagnosis of intra-uterine growth retardation. Obstet Gynecol Survey 1986; 41 :187-99.
Engstrom JL, Sittler CP. Fundai height measurement: part 1- Techniques for measuring fundai height. J Nurse Midwifery 1993; 38(1 ):5-16.
Beazley JM, Underhill RA. Falacy of the fundai height. Br Med J 1970; 4(732):404-6.
Engstrom JL, McFarlin BL, Sampson MB. Fundai height measurement: part 4- Accurracy of clinicians identification of the uterine fundus during pregnancy. J Nurse Midwifery 1993; 38(6):318-23.
Cunningham FG, MacDonald PC, Gant NF, editors. Williams Obstetrics. 18th ed. Norwalk; 1989.
Westin B. Gravidogram and fetal growth. Acta Obstet Gynecol Scand 1977; 56:273-82.
Jacobsen G. Prediction of fetal growth deviations by use of symphysis-funds height measurements. lnt J Technol Assess Health Care 1992; 8(1 ): 152-9.
Ogunranti JD. Fundai height in normal pregnant Nigerian women: anthropometrics gravidogram. lnt J Gynecol Obstet 1990; 33(4):299-305.
Hakkanson A, Aberg A, Nyberg P, Schersten B. A new symphysis-fundus height growth chart based on a well defined female population with ultrasound-dated singleton pregnancies. Acta Obstet Gynecol Scand 1995; 7 4:682-6.
Belizan JM, Villar J, Nardin JC, Malamud J, De Vicurna LS. Diagnosis of intra uterine growth retardation by a simple clinicai method: Measurement of uterine height. Am J Obstet Gynecol 1978; 131 (6):643-6.
Fescina RH, Quevedo C, Martell M, Nieto F, Schwarcz R. La medida de la altura uterina como método sencillo para predicir el crecimento fetal. Montevidéo: Centro Latinoamericano de Perinatologia y Desarrollo Humano; 1983. 13p.
Ghate M, Pratinidhi A, Gupte A. Risk prediction charts for low birth wieght. lndian Pediatr 1996; 33:1-22.
Barini R. Avaliação da curva de crescimento da altura uterina como método para estimar o peso fetal [tese]. Campinas: Faculdade de Ciências Médicas, Universidade Estadual de Campinas; 1989.
Buhmann L, Elder WG, Hendricks B, Rahn K. A comparasion of caucasian and Southeast Asian Hmong uterine fundai height. Acta Obstet Gynecol Scand 1998; 77(5): 521-6
