DOCSLIB.ORG

A Comparison of Manual and Ultrasound Measurements Offundal Height David W

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Comparison of Manual and Ultrasound Measurements Offundal Height David W Original Research Articles A Comparison of Manual and Ultrasound Measurements ofFundal Height David W. Euans, MD; Pamela D. Connor, PhD; Ricardo G. Hahn, MD; Wm. MacMillan Rodney, MD; and Kristopher L. Arheart, EdD flew Orleans, Louisiana, an d Memphis, Tennessee Background. Uterine fundal height has long been used Results. Ultrasound fundal height and manual fundal to assess fetal growth. The common prediction rule height were equivalent (Ps.01, R2 = .92). Regression I states that the distance in centimeters between the pubic analysis in normal weight and obese patients showed I symphysis and the top of the fundus equals the gesta­ that both methods have the same predictive power in tional age in weeks. The correlation holds best between determining fetal age. weeks 18 and 32. This study compares manual and Conclusions. Manual measurements are still a reliable ultrasound measurements of fundal height. and inexpensive means o f evaluating the course o f preg­ Methods. We compared palpated and ultrasound sym- nancy. Ultrasound is needed when there is a size-vs-date physis-fundal height. We then compared both measure­ discrepancy. Ultrasound is also useful for teaching the ments with gestational age as determined by usual ultra­ measurement of fundal height. sound measurements. Patients were statistically separated by weight into two groups: normal and obese. We hypoth­ Key word,s. Anthropometry; ultrasonography, prenatal; esized that manual measurements of fundal height would obesity; symphysis-fundal height measurement. be affected by obesity and race. ( / Fam Pract 1995; 40:233-236) The most accurate clinical predictor o f gestational age and although measuring techniques can be hindered by ex­ date of confinement is a reliably reported date of last trinsic factors, such as maternal habitus3 and bladder full­ menstrual period.1 Research from the past decade sug­ ness.4 Gestational age can be estimated even without a gests that clinical markers, such as last menstrual period reliable date o f last menstrual period, especially when cou­ and symphysis-fundal height, when consistently moni­ pled with other clinical markers.5’6 The accuracy o f man­ tored and applied, can be as accurate as fetal ultrasound in ual fundal height measurements alone, however, has been predicting gestational age.2 Ultrasound, on the other questioned. Issues have included the general imprecision band, is not necessarily a reliable indicator of fetal age of the measurement,7 variability o f measurement tech­ throughout the entire pregnancy. niques,8 problems of predicting intrauterine growth re­ Several timely measurements o f symphysis-fundal tardation,9’10 and differences related to race.11 height can yield an accurate estimated gestational age, The height of the uterine fundus during pregnancy has been used as a predictor of gestational age for many years. In 1906, McDonald12 established the distance from Submitted, revised, December 5, 1994. the symphysis pubis to the umbilicus to be between 12 Smn the Department o f Family Medicine, Louisiana State University, New Orleans and 20 cm. The fundal height between weeks 18 and 32, (O.W.E.); and the Department of Family Medicine (P.D.C., W.M.R.), the UT/ baptist HealtbPlex Family Medicine Residency Program (R .G .H .), UT-AM I/St measured in centimeters from the upper border of the brands Family Practice Residency Program (W .M.R.), an d the Division o f Biosta- pubic symphysis around the curve of the abdomen and units and Epidemiology, Department o f Preventive Medicine, (K.L.A .), University of Tennessee, Memphis. D r Euans was a t UT-AM I/St Francis Family Practice Rcsi- over the top o f the uterine fundus, approximates the ges­ tlncy Program at the time this research was conducted. Requestsfor reprints should be tational age in weeks. Manual symphysis-fundal height oddressed to David W. Euans, MD, Department of Family Medicine, 1542 Tulane bn, New Orleans, LA 70112. measurement is actually used to estimate the size or vol- 0 W95 Appleton & Lange ISSN 0094-3509 The Journal o f Family Practice, Vol. 40, No. 3(Mar), 1995 233 Fundal Height Measurement Euans, Connor, Hahn , etal time o f the uterus, which in turn yields an estimated measurement, observers were not blinded to either man­ gestational age. The measurement becomes less accurate ual or ultrasonographic measurements. We did not test I in the final weeks o f pregnancy (ie, 36 weeks or later) for interrater reliability. because of positional shifts of the fetus.13 Patients were separated by weight into one of two Our research question was whether measuring the groups: normal or obese. Because of the variety of defini symphysis-fundal height manually rather than ultrasono- tions for obesity, two methods were used to identify over graphically would yield different estimates o f gestational weight patients. First, any individual who was 20% over age. We hypothesized that manual measurements of fun­ ideal body weight (IBW) as defined by the Metropolitan dal height would be affected by obesity. Life Scales16 was classified as obese. Measurement ofbodi mass index (BMI) was chosen as the second method of' Methods classification because it has a stronger statistical relation ship with body fat than does relative weight for height.1' Study participants were selected from consecutive obstet­ A BMI value o f greater than 27.3 kg/cm 2 was used as the ric patients presenting to our academic family practice indicator of obesity. BMI was determined by the follow residency center for routine fetal ultrasound between Jan­ ing formula: BMI in kg/cm2=(weight in pounds!, uary and April 1991. One hundred fifty-nine patients (height in inches)2X703.1.18 carrying a single fetus between 11 and 42 weeks’ gesta­ Simple linear regression and analysis of covariance! tional age were selected to participate.14 Measurements were used to analyze the data. Only 12% of the sample for determining fetal age included biparietal diameter, had manual and ultrasound estimates that differed, head circumference, abdominal circumference, and femur by more than 2 weeks. To measure how well manual length. Because the purpose of our study was to compare fundal height measurements approximated ultrasounc ultrasonographic and manual measurements, ultrasound measures, the parameters o f a simple linear regressions was used to locate the true fundal height. This measure­ ultrasound on manual fundal height were tested. If the ment was recorded, along with the fundal height as de­ manual measurements were to perfectly match the ultra termined by traditional palpation. A comparison was sound measurements, the regression equation would be made between palpated and ultrasound symphysis-fundal ultrasound=0.0 + l.OXmanual. Therefore, a test in which height. Patients were statistically subdivided into two the regression equation intercept=0 and the slope=1 de groups: those who were within a normal weight range for termines the accuracy of the approximation. Equation their height and those who were classified as obese. parameters were tested for all data combined and foil Fundal height measurements were obtained for each obese and normal groups as determined by the two critc patient in a uniform manner. Patients were placed on an ria. An analysis of covariance was used to test whether tkj examination table in a supine position with legs fully ex­ regression equations differed between groups according tended and arms to the side. The examining physician to obesity or race. A significant F test o f the interactior palpated the uterine fundus, and the measuring tape was between the covariate (manual fundal height) and group placed face down in an effort to eliminate measurement (obesity or racial) indicates that group affiliation affect bias.15 Measurements were made from symphysis to fun­ the slope; a significant F test o f the group main effec: dus, over the fetal axis, with relaxed abdominal and uter­ indicates that group membership affects the intercept ine musculature. The ultrasound fundal height was deter­ Test results with a significance level o f .05 or less were mined by positioning the transducer at the superior aspect considered statistically significant. of the uterus so that the top o f the fundus was visible on the imaging screen. A finger was placed under the probe Results until its shadow coincided with the uppermost aspect of the uterus. This point was marked on the abdomen. The O f the 159 patients selected for the study, only 119 hit distance from the superior aspect o f the pubic symphysis both manual and ultrasound fundal height measure to this point represented the true fundal height. Fetal age ments. Forty patients did not receive both measurement was then determined by ultrasound using multiple mea­ because o f differences in medical coverage arrangements surements on all subjects. All ultrasound measurements Therefore, all results are based on these 119 patients. were performed by the authors, using an A T L/A D R The regression of ultrasound fundal height on mail 4000 ultrasound scanner with a 3.5-MHz probe. ual fundal height was significant (P <.01) and had anil Fundal height was measured by residents and faculty value o f .92. The results o f the tests for slope=l ait physicians with obstetric care experience ranging from a intercept=0 were not significant (both P=N S), indial few months to more than 15 years. Residents’ measure­ ing that there is no significant difference between man* ments were verified by faculty. When taking a second and ultrasound measurements of fundal height. The rcl 234 The Journal of Family Practice, Vol. 40, No. 3(Mar), 191 Fundal Height Measurement Euans, Connor, Hahn, et al Fundal Height by 2 Measures (cm) Figure 1. Comparison o f manual and ultrasound measurements of fundal height in 119 patients. Figure 2.
Load more

Recommended publications
  • Symphysio Fundal Height (SFH) Measurement As a Predictor of Birth Weight
    Faridpur Med. Coll. J. 2012;7(2):54-58 � Original Article Symphysio Fundal Height (SFH) Measurement as a Predictor of Birth Weight Z Parvin1, S Shafiuddin2, MA Uddin3, F Begum4 Abstract : Fetal weight is a very important factor to make a decision about labor and delivery. Assuming that in large fetuses, dystocia and other complications like cerebral edema, neurological damage, hypoxia and asphyxia may result during or after the delivery. On the other hand, one of the causes of high perinatal mortality in our country is high rate of low birth weight. Rural people may not have access to ultrasonography which is one of the methods to predict birth weight. For these people alternative easy method is necessary. So we can assess fetal birth weight by measuring symphysio-fundal height. Total 100 consecutive pregnant women of gestational age more than 32 weeks admitted for delivery in the Obstetric and Gynaecology department of Faridpur General Hospital were the subject of this study. After selection of cases, a thorough clinical history was taken and elaborate physical examination was done. Common criteria for collection of data were followed in every case. The fetal weight estimated by Johnson's formula was recorded in the predesigned data sheet and then was compared with birth weight following delivery of the fetus. Collected data were compiled and relevant statistical calculations were done using computer based software. Statistical tests (Correlation) were done between actual birth weight (taken as dependant variable) and fetal weight (found by Johnson's Formula), symphysio fundal height (SFH), pre-delivery weight and height of the patients (taken as independent variables) and the tests revealed that actual birth weight was significantly correlated with fetal weight (found by Johnson's Formula), SFH, pre-delivery weight and height of the patients.
    [Show full text]
  • Magnetic Resonance Imaging
    Published online: 2021-07-30 OBS/GYNEC Magnetic resonance imaging ‑ A troubleshooter in obstetric emergencies: A pictorial review Rohini Gupta, Sunil Kumar Bajaj, Nishith Kumar, Ranjan Chandra, Ritu Nair Misra, Amita Malik, Brij Bhushan Thukral Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Correspondence: Dr. Rohini Gupta, Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi ‑ 110 029, India. E‑mail: [email protected] Abstract The application of magnetic resonance imaging (MRI) in pregnancy faced initial skepticism of physicians because of fetal safety concerns. The perceived fetal risk has been found to be unwarranted and of late, the modality has attained acceptability. Its role in diagnosing fetal anomalies is well recognized and following its safety certification in pregnancy, it is finding increasing utilization during pregnancy and puerperium. However, the use of MRI in maternal emergency obstetric conditions is relatively limited as it is still evolving. In early gestation, ectopic implantation is one of the major life‑threatening conditions that are frequently encountered. Although ultrasound (USG) is the accepted mainstay modality, the diagnostic predicament persists in many cases. MRI has a role where USG is indeterminate, particularly in the extratubal ectopic pregnancy. Later in gestation, MRI can be a useful adjunct in placental disorders like previa, abruption, and adhesion. It is a good problem‑solving tool in adnexal masses such as ovarian torsion and degenerated fibroid, which have a higher incidence during pregnancy. Catastrophic conditions like uterine rupture can also be preoperatively and timely diagnosed. MRI has a definite role to play in postpartum and post‑abortion life‑threatening conditions, e.g., retained products of conception, and gestational trophoblastic disease, especially when USG is inconclusive or inadequate.
    [Show full text]
  • International Standards for Symphysis-Fundal Height Based on BMJ: First Published As 10.1136/Bmj.I5662 on 7 November 2016
    RESEARCH OPEN ACCESS International standards for symphysis-fundal height based on BMJ: first published as 10.1136/bmj.i5662 on 7 November 2016. Downloaded from serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: prospective cohort study in eight countries Aris T Papageorghiou,1 Eric O Ohuma,1,2 Michael G Gravett,3,4 Jane Hirst,1 Mariangela F da Silveira,5,6 Ann Lambert,1 Maria Carvalho,7 Yasmin A Jaffer,8 Douglas G Altman,2 Julia A Noble,9 Enrico Bertino,10 Manorama Purwar,11 Ruyan Pang,12 Leila Cheikh Ismail,1 Cesar Victora,6 Zulfiqar A Bhutta,13 Stephen H Kennedy,1 José Villar,1 On behalf of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) For numbered affiliations see ABSTRACT visible during examination. The best fitting curve was end of article. OBJECTIVE selected using second degree fractional polynomials Correspondence to: To create international symphysis-fundal height and further modelled in a multilevel framework to A Papageorghiou, Nuffield standards derived from pregnancies of healthy women account for the longitudinal design of the study. Department of Obstetrics & Gynaecology, University of with good maternal and perinatal outcomes. RESULTS Oxford, John Radcliffe Hospital, DESIGN Of 13 108 women screened in the first trimester, 4607 Headington, Oxford OX3 9DU, UK aris.papageorghiou@obs-gyn. Prospective longitudinal observational study. (35.1%) met the study entry criteria. Of the eligible ox.ac.uk SETTING women, 4321 (93.8%) had pregnancies without major Additional material is published Eight geographically diverse urban regions in Brazil, complications and delivered live singletons without online only.
    [Show full text]
  • Maternal Assessment 1
    University of Babylon / College of Nursing University of Babylon College of Nursing MATERNAL ASSESSMENT 1 SUPERVISOR BY : - DR.AMEAN STUDEND NAME: - ZAINAB ALI HUSSEIN ROSSUL HAMZA ALYAA NEMIA The aim of maternal assessment 2 1- to identify the high risk of cases 2- to prevent and treat early complication 3- to ensure from contained risk assessment and provide on going to primary health care 4- educate the mother about physiology of pregnancy and labor and care newborn The procedures of the first visit 3 1- Demographic data ( age – occupation- LMP- EDD- P G A- type of labor – blood group + RH) 2- Family history 3- past history 4 -obstetric history 5 -mensterial history Signs of pregnancy 4 - Breast changes - Nausea & vomiting - Amenorrhea - Frequent urination - Fatigue & uterine enlargement - Line anigra - Melasma - Goodell signs - Hegar signs - Braxton contraction First Trimester 5 * (Subjective symptoms) - Amenorrhoea - Morning sickness - Frequent of micturation - Breast discomfort - Fatigue - breast changes Objective signs 6 - breast changes - abdominal enlargment - pelvic changes * ( THE TESTING FOR DIAGNOSIS OF PREGNANCCY IN FIRST TRIMESTER ( BHCG) AND ( U/S) 7 -gestational sac( 29-35) day of gestation - gastational age to determine by the detecting the following structures - cardiac activity in (6 week) and heart rate at (10 weeks) - embryo growth by 7 weeks Second trimester 8 General examination - Breast changes - Enlargment of lower abdomen - abdomenal examination :- included:- a-inspaction:-
    [Show full text]
  • Best Practice & Research Clinical Obstetrics and Gynaecology
    Author's personal copy Best Practice & Research Clinical Obstetrics and Gynaecology 23 (2009) 809–818 Contents lists available at ScienceDirect Best Practice & Research Clinical Obstetrics and Gynaecology journal homepage: www.elsevier.com/locate/bpobgyn 6 Fetal growth screening by fundal height measurement Kate Morse, Bsc (Hons) DPSM RM RGN, Specialist Midwife, Amanda Williams, MSc Dip HE RM RGN, Specialist Midwife, Jason Gardosi, MD FRCOG FRCSED, Professor * West Midlands Perinatal Institute, Birmingham B6 5RQ, UK Keywords: Fundal height assessment is an inexpensive method for screening fundal height for fetal growth restriction. It has had mixed results in the litera- symphysio-fundal height ture, which is likely to be because of a wide variety of methods customised charts used. A standardised protocol of measurement by tape and plot- ultrasound scan ting on customised charts is presented, which in routine practice fetal biometry has shown to be able to significantly increase detection rates, uterine artery Doppler while reducing unnecessary referral for further investigation. Fundal height measurement needs to be part of a comprehensive protocol and care pathway, which includes serial assessment, referral for ultrasound biometry and additional investigation by Doppler as required. Ó 2009 Published by Elsevier Ltd. The urgency for improving antenatal detection of the small-for-gestation (SGA) or intrauterine growth-restricted (IUGR) baby increases with the awareness that fetal growth restriction is a common precursor of adverse outcome. While we have yet to establish reliable tests to predict which pregnancies are at risk of developing IUGR, surveillance of fetal growth in the third trimester of pregnancy continues to be the mainstay for the assessment of fetal well-being.
    [Show full text]
  • Licit and Illicit Drug Use During Pregnancy: Maternal, Neonatal and Early Childhood Consequences
    SUBSTANCE ABUSE IN CANADA 2013 Licit and Illicit Drug Use during Pregnancy: Maternal, Neonatal and Early Childhood Consequences By Loretta Finnegan With A Call to Action by Franco Vaccarino and Colleen Dell This document was published by the Canadian Centre on Substance Abuse (CCSA). CCSA activities and products are made possible through a financial contribution from Health Canada. The views of CCSA do not necessarily represent the views of the Government of Canada. The subjects in the photographs used throughout this publication are models who have no relation to the content. The vignettes are fictional and do not depict any actual person. Suggested citation: Finnegan, L. (2013). Substance abuse in Canada: Licit and illicit drug use during pregnancy: Maternal, neonatal and early childhood consequences. Ottawa, ON: Canadian Centre on Substance Abuse. © Canadian Centre on Substance Abuse 2013. CCSA, 75 Albert St., Suite 500 Ottawa, ON K1P 5E7 Tel.: 613-235-4048 Email: [email protected] This document can also be downloaded as a PDF at www.ccsa.ca. Ce document est également disponible en français sous le titre : Toxicomanie au Canada 2013 : Consommation de drogues licites et illicites pendant la grossesse : Répercussions sur la santé maternelle, néonatale et infantile ISBN 978-1-77178-041-4 Licit and Illicit Drug Use during Pregnancy: Maternal, Neonatal and Early Childhood Consequences Prepared for the Canadian Centre on Substance Abuse Loretta P. Finnegan, M.D., LLD, (Hon.), ScD (Hon.); President, Finnegan Consulting, LLC; Professor of Pediatrics, Psychiatry and Human Behavior, Thomas Jefferson University (Retired); Founder and Former Director of Family Center, Comprehensive Services for Pregnant Drug Dependent Women, Philadelphia, PA; Former Medical Advisor to the Director, Office of Research on Women’s Health, National Institutes of Health, U.S.
    [Show full text]
  • AWH Pregnancy Confirmation Handout
    Ranae Yockey, DO, FACOG 880 West Central Road Allison Corro, PA-C Busse Medical Building, Suite 6200 Madison Monk, PA-C Arlington Heights, IL 60005 Nicole Quigley, APN, CNM Phone: (847) 618-0730 Rosina Victor, APN, CNM Fax: (847) 618-0799 Megan Bishoff, APN, CNM Pregnancy Information Congratulations on your pregnancy! Before you know it, you will be giving birth. Here is some information on what you may experience during your pregnancy as well as baby’s development. You’ll be seeing your healthcare provider a lot for the duration of your pregnancy. In general, you can expect to go in every month until you are 28 weeks along. From weeks 28 to 36, your visits will likely increase to two appointments a month. Once you hit the 36-week mark, plan on a weekly check-up. (While typical, this schedule is not true for all pregnancies. If you are considered high risk, for example, you may be seeing your healthcare provider more often.) For any urgent questions or concerns outside of our normal business hours, please use our answering service number to contact our on-call provider. Answering Service: (855) 750-4897 Pregnancy Baby’s Size & What to Expect at your Common Symptoms Baby’s Development Week Weight appointment Morning Sickness Expect Growth Breast Changes from almost ¼ Frequent inch long (Grain of Heart begins to Urination Rice) to ½ or ¾ beat Food and Smell inch long All major organs Ultrasound to 8 Aversions (Similar to the Size - are formed determine cause for Mood Changes of a Raspberry) 6 The face, fingers, amenorrhea Back pain toes and eyes Abdominal appear Cramping (Pregnancy Confirmation) Excess Salivation Sometimes, No symptoms Less Nausea Discuss Medical and Expanding Uterus Family History The head is large, Bladder Relief Growth is about 2 Physical Exam since the brain Initial Pregnancy Blood Skin changes grows faster than ¼ inches long and tests: blood type and Increased the other organs.
    [Show full text]
  • Fundal Height As a Predictor of Early Preterm Triplet Delivery
    Fundal Height as a Predictor of Early Preterm Triplet Delivery Yoshie Yokoyama College of Medical Technology, Kyoto University he purpose of this study was to create graphs of fundal gestational age were obtained from records in Maternal and Theight parameters in triplet pregnancies compared with Child Health Handbooks. This handbook was established by those in twin pregnancies, and to investigate whether larger fundal heights in triplet pregnancies would predispose them to the Maternal and Child Health Law in Japan and is provided earlier delivery (before 34 weeks). The subjects were 727 twin by the governor after a report of pregnancy. The purpose of pregnant women and 133 triplet pregnant women, who deliv- this handbook is the maintenance of maternal and child ered after 1984. Triplet pregnancies showed significantly health: medical examinations during pregnancy, the condi- higher fundal heights compared with twin pregnancies at each tion of the newborn, the progress of infant growth, periodic gestational age (weeks). In triplet pregnancies, a single fundal height measurement above the 90th percentile before 34 medical examinations for the infant, and preventive injec- weeks yielded a sensitivity of 31.3% and specificity of 82.4% tions are recorded. Further, it is established by the Maternal for delivery before 34 weeks, with a positive predictive value and Child Health Law that all pregnant women receive of 50.0% and a negative predictive value of 68.0%. After medical examinations during pregnancies. Pregnant women adjusting for each associated factor using logistic regression, are examined by obstetricians, and their fundal heights are the risk of preterm labour was not significantly associated with routinely measured in all cases using a flexible nondistensible a single fundal height measurement above the 90th percentile recorded before 34 weeks.
    [Show full text]
  • Uterine Size and EDD Discrepancy
    Uterine Size and EDD Discrepancy Study Group Module Uterine Size and EDD Discrepancy National Midwifery Institute, Inc. Study Group Coursework Syllabus Description: This module explores uterine size, fundal growth patterns, their normal variations, when to refer and its implications in midwifery practice. It includes recommended reading materials in print and online, and asks students to complete short answer questions for assessment, long answer questions for deeper reflection, and learning activities/projects to deepen your hands-on direct application of key concepts. Learning Objectives: ● Review EDD calculations. ● Define IUGR, SGA and LGA. ● Identify the risks for IUGR or SGA babies, once they are born. ● Identify the risks for babies considered to be LGA. ● Understand the significance of polyhydramnios and oligohydramnios. ● Identify possible signs of twin pregnancy. ● Review possible signs of breech presentation in pregnancy. ● Understand why an abnormal fetal presentation can result in size/dates discrepancy. ● Review uterine abnormalities that can contribute to fetal position and size/dates discrepancy. ● Understand how fibroids may be affected during pregnancy and birth. ● Draft practice guidelines for responding to uterine size and EDD discrepancy. Learning Activities: ● Research and read appropriate study sources, seeking out additional study sources where needed ● Complete short answer questions in attached module document for assessment ● Complete long answer questions for deeper reflection in attached module document for assessment ● Complete learning activities listed in attached module document for assessment ○ Draft practice guidelines for size/dates discrepancies ● Submit work to Study Group Course Coordinator ● Reflect on feedback from Study Group Course Coordinator and re-submit work as needed © National Midwifery Institute, Inc. Revised 2018 Study Group Module: Uterine Size and EDD Discrepancy Study Sources (print): The following texts are recommended for completion of this module.
    [Show full text]
  • (Ananas Comosus (L.) Merr.) Juice on Fundal Height in Primigravida Mothers During Postpartum Period
    Harianja WY, et al. Belitung Nursing Journal. 2017 April;3(2):134-141 Accepted: 28 February 2017 http://belitungraya.org/BRP/index.php/bnj/ © 2017 The Author(s) This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ORIGINAL RESEARCH ISSN: 2477-4073 THE IMPACT OF PINEAPPLE (ANANAS COMOSUS (L.) MERR.) JUICE ON FUNDAL HEIGHT IN PRIMIGRAVIDA MOTHERS DURING POSTPARTUM PERIOD Winda Yunyaty Harianja1*, Onny Setiani2, Umaroh3, MeLyana NuruL Widyawati1, Imam Djamaludin Mashoedi1, Sri Endang Pujiastuti1 1Magister Applied Midwifery, Health Ministry Polytechnic Semarang, Semarang, Indonesia 2Fakultas Kedokteran, Universitas Diponegoro, Semarang, Indonesia 3Prodi DIII Kebidanan, Health Ministry Polytechnic Semarang, Semarang, Indonesia *Corresponding author: Winda Yunyaty Harianja, S.ST, M.Tr. Keb Magister Applied Midwifery, Health Ministry Polytechnic Semarang Jl. Tirto Agung, Pedalangan, Banyumanik, Kota Semarang, Jawa Tengah, Indonesia (50268) E-mail: [email protected] ABSTRACT Background: Failure in the process of uterine involution can result in bleeding if not treated immediately. Provision of pineapple (Ananas Commosus (L). Merr) juice can be administered as a medicinal plant therapy to prevent sub involution of the uterus and is considered to speed up the recovery process of the uterine involution. Objective: This study aims to examine the effect of pineapple (Ananas Commosus (L). Merr) juice to decrease fundal height in primigravida mothers during postpartum period. Design: This was a quasi-experimental study with non-equivalent control group, conducted in the working area of the Health Center (Puskesmas) of Jekulo Kudus Indonesia on 1-30 December 2016.
    [Show full text]
  • Fundal Height Measuring with a Tape Measure
    King Edward Memorial Hospital Obstetrics & Gynaecology CLINICAL PRACTICE GUIDELINE Fundal height: Measuring with a tape measure This document should be read in conjunction with the Disclaimer Aims To determine the gestation and growth of the fetus. To identify multiple pregnancies and complications of pregnancy e.g. amniotic fluid disorders, and fetal growth disturbances. Background information Refer to the Australian Government Department of Health Pregnancy Care Guidelines (Section 22: Fetal Growth Restriction and Well-being: 22.1.3: Assessing Fetal Growth) for background information. Key points 1. At each antenatal visit from 24 weeks, measure fundal height in centimetres.1 2. Refer women after 24 weeks gestation with a fundal height ≥3cm less than expected, a single fundal height which plots below the 10th centile or serial measurements that demonstrate slow or static growth by crossing centiles for ultrasound measurement of fetal size.1 For ultrasound requests for midwifery clinics / MGP patients: Refer to KEMH Guideline, O&G: Pathology and Ultrasound Ordering by Midwife/Nurse/Nurse Practitioner: Ultrasound: Midwifery Clinics & Midwifery Group Practice Requests. 3. Refer women in whom measurement of fundal height is inaccurate (for example: BMI>35, large fibroids, polyhydramnios) for serial assessment of fetal size using ultrasound.1 Page 1 of 3 Fundal Height: Measuring with a Tape Measure Procedure 1. Obtain maternal consent. 2. Encourage the woman to empty her It has been demonstrated the fundal height bladder if she has not done so in the last can be 3 cm higher at 17-20 weeks gestation 30 minutes. if the woman has a full bladder.2 3.
    [Show full text]
  • 1 Estimating the Gestational Age and Pregnancy Trimester in the Niger Maternal Nutrition Project Rebecca R. Young, K. Ryan Wesse
    Estimating the Gestational Age and Pregnancy Trimester in the Niger Maternal Nutrition Project Rebecca R. Young, K. Ryan Wessells, Césaire T. Ouédraogo, Sonja Y. Hess Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA, USA Corresponding authors: Rebecca R. Young ([email protected]) and K. Ryan Wessells ([email protected]) Study Overview The Niger Maternal Nutrition (NiMaNu) project is an implementation research project, using a quasi- experimental descriptive study design. Households with potentially eligible pregnant women from 85 randomly selected villages within the catchment area of 18 integrated health centers (CSI) were identified by employing a multi-stage clustered sampling design. Briefly, 18 CSI serving rural areas were selected by convenience sampling and randomized to the timing of participation. Within the catchment area of each CSI, 6-8 villages were randomly selected from each CSI. Participants were enrolled over a period of eighteen months through two community-based cross sectional surveys conducted at baseline and six months later after the implementation of a programmatic intervention (i.e. endline survey). The study was approved by the National Ethic Committee in Niamey (Niger) and the Institutional Review Board of the University of California, Davis (USA). Participants were asked to sign a written consent or fingerprint. The study was registered at www.ClinicalTrial.Gov as NCT01832688. Data Collection to Date Gestational Age Each study participant was interviewed and examined twice one month apart. Because ultrasound was not available and the majority of study participants were illiterate, several methods were used to date a woman’s gestational age. First, pregnant women were asked to estimate their last menstrual period (LMP) based on a time reference they were most familiar with.
    [Show full text]