Lauren is absolutely delighted. She has finally fitted into her 1st pair of pumps with her splints. It’s so hard finding shoes that fit with her splints. Her words were “Yes, I’m so lucky”. Little things like a pair of shoes, have just brought a huge smile
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The UK has one of the worst stillbirth rates in the developed world and at least 1 third of stillbirths are related to fetal growth restriction. At least 10% of ALL babies born are growth restricted. Growth restriction in an unborn child is the single largest risk factor for stillbirth, especially when it goes unrecognised before birth.1
SFH is a widely used method of monitoring fetal growth usually measured from 28 weeks gestation. It is, however, not very accurate in detecting babies that are small2 with as little as 30%3,4 being reported. Furthermore, it has a high degree of variance between professionals5. However, its speed and cost effectiveness can still make it a useful screening tool to this day.
For this reason, it is important to measure as accurately as possible. It is also important to listen to mums regarding concerns about her baby’s movements and growth (especially if she is multiparous).
Watch our mini video to empower you to take an accurate measurement and help more babies arrive safely:
Measure once and plot immediately on a customised growth chart. If growth is not following a normal pattern, a referral should be made for an ultrasound scan which should take place within 72 working hours.
Full SFH training is available as part of The Perinatal Institute’s Growth Assessment Programme (GAP) for the ultimate detection of growth restricted babies. Please visit their website for more information.
All clinicians should use the same, standardised technique. This will decrease the degree of error and variation.
If a problem is identified, the test shouldn’t be repeated by another clinician as the inter-observer variation can be as large as 10cm depending on technique. Instead, there should be direct referral for an ultrasound scan.
Patients should have an empty bladder as a full bladder can add 2cm to the measurement.
Measurements should be taken every 2 – 3 weeks. If the mother is already having serial scans 2-3 weekly, there is no need to measure and plot fundal height measurements between her scans. However, if serial scanning is sporadic i.e. only at 28 and 34 weeks continue fundal height measurements and refer if any concerns around growth velocity.
When using customised growth charts, do not allow for the descent of the head. The curves do not flatten towards term; uncompromised babies should continue growing until delivery. Measure in the same way, and if there is static/slow growth referral should be made for an ultrasound scan.
Transverse lie – measure in the same way and record position. The baby’s position is irrelevant, measure from the highest point of the fundus to the symphysis pubis and plot the metric measurement. If you are concerned with the serial plots, referral should be made for an ultrasound scan.
Multiple pregnancies – do not measure fundal height. This cohort of women should be having serial scanning to assess individual growth
If a mother has an increased body mass index (BMI >35) fundal height measurements will not be accurate. This cohort of women should be having serial scanning to assess fetal growth.
In some rural areas of the world, in specific populations, SFH can be much more useful6. The Cochrane database reviews7 could only find one randomised controlled trial8.
Gardosi J, Madurasinghe V, Williams M, Malik A, Francis A. Maternal and fetal risk factors for stillbirth: A population based study. BMJ 2013;346:F108.
Rosenberg K, Grant JM, Hepburn M. Antenatal detection of growth retardation: Actual practice in a large maternity hospital. BJOG 1982;89:12-15.
Hall M, Chng PK, MacGillivray I. Is routine antenatal care worthwhile? Lancet 1980;ii:78-80
Belizan JM, Villar J, Nardin JC, Malamud J, De Vicurna LS. Diagnosis of intrauterine growth retardation by a simple clinical method: measurement of fundal height. AmJOG 1978;131:643-6
Bailey SM, Sarmandal P, Grant JM. A comparison of three methods of assessing inter-observer variation applied to measurement of the symphysis-fundal height. BJOG 1989;96:1266-71
Challis K, Osman NB, Nystrom L, Nordahl G, Bergstrom S. Symphysis-fundal height growth chart of an obstetric cohort of 817 Mozambican women with ultrasound dated singleton pregnancies. Trop Med Int Health.2002 Aug;7(8):678-84
Robert PJ, Ho JJ, Vallipan J, Sivasangari S. Measuring the height of the uterus from the symphysis pubis (SFH) in pregnancy for detecting problems with fetal growth. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.:CD008136. DOI:10.1002/14651858.CD008136.pub2
Lindhard A, Nielsen PV, Mouritsen LA, Zachariassen ALA, Sorensen HU, Roseno H, The implications of introducing the symphyseal-fundal height measurement. A prospective randomized controlled trial. BJOG 1990;97:675-80
This post is dedicated to achievements children with FACS . We want to hear from parents whose children have FACS, and what they have achieved, it can be from the smallest achievement to the biggest or just showing how proud you are of your child. You can send the info to firstname.lastname@example.org or send via inbox on our FACSA Facebook page. They will be put on this page with pictures and you can nominate them at any time for anything …..even little things are achievemnets….. Lets see our FACS children
Monday 28th April
Here we have a picture of Joshua last year at his foundation stage Graduation. On his Certificate of Achievement he has been awarded for always trying hard in his subjects, making improvements in literacy and for being a confident little boy.
All fabulous traits to have :)
Sunday 27th April
When a parent enters into the world of parenthood it is automatically presumed that it will be a fabulous journey, will all go to plan as viewed when pregnant. In many cases and for the lucky ones this does happen, however when your child is ill or medical conditions, unforeseen circumstances happen that illusion is a million miles apart.
For me being a parent with children with SEN (special education needs) and disabilities it (and SEN parents will agree) can be a very lonely, frustrating and fearsome journey. Family and friends are there for us in our everyday lives to support us, unfortunately they are not in the position so don’t really have an understanding of the circumstances we are in.
I have just read the book “Warrior Mums” by Author Michelle Daly. Every Sunday on Twitter Michelle runs a series called Warrior Mums and this features ladies who have gone through for some life changing experiences, highs and lows of becoming parents, challenges that they have overcome in life. Her book features 11 very brave and honest ladies who have spoken about their reason for being a “Warrior Mum”
Times can be very hard, stressful and a lot of people when going through trying times will question “why me” “life isn’t fair” .This book is a fabulous read as it proves by all the stories featured that yes, we are often thrown difficulties to face, but these difficulties can be overcome and no matter how bad a situation is, there can come some good and ultimately “Things happen for a reason” It also leaves you with the feeling that we are not alone. There are people out there that care, who will help and support you in times of need, for many people it is about reaching out for help and accepting it. Accepting circumstances/situations is often the 1st big boundary to overcome.
Well done Michelle for writing such an inspirational book about other peoples journeys and all you lovely ladies featured ….. a compelling read for each and every one of you, you are all definitely Warrior Mums :)
Warrior Mums is available to buy at Amazon http://www.amazon.co.uk/Warrior-Mums-Michelle-Daly-ebook/dp/B00JG093IU/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1398549926&sr=1-1&keywords=michelle+daly+warrior+mums
Plot For Happy Death Day
Movie ‘Happy Death Day’ was released in October 12, 2017 in genre Horror. Christopher B. Landon was directed this movie and starring by Jessica Rothe. This movie tell story about A college student relives the day of her murder over and over again as she tries to discover her killer’s identity.
Christopher B. Landon.
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‘It’ is a movie genre Adventure, was released in September 5, 2017. Andy Muschietti was directed this movie and starring by Jaeden Lieberher. This movie tell story about In a small town in Maine, seven children known as The Losers Club come face to face with life problems, bullies and a monster that takes the shape of a clown called Pennywise.
Roy Lee, Dan Lin, Seth Grahame-Smith, Barbara Muschietti, David Katzenberg.
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New Line Cinema, Vertigo Entertainment, Lin Pictures, RatPac-Dune Entertainment, KatzSmith Productions.
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Blade Runner 2049 (2017) Duration 163 mins Genre Action, Mystery, Science Fiction, Thriller. In Cinemas October 4, 2017 Language English. Country United States of America. Plot For Blade Runner 2049 ‘Blade Runner 2049’ is a movie genre Action, was released … Continue reading