BACKGROUND: The antenatal detection of fetal growth restriction is a focus point of antenatal care. If detected fetal demise may be prevented and perinatal complications could be managed more appropriately. AIMS: To investigate whether introducing serial plotting on customised fundal height charts can increase the detection rate of small for gestational age (SGA) fetuses in low risk nulliparous women attending antenatal clinics in a public teaching hospital in Adelaide, South Australia. METHODS: An observational study was employed to compare SGA detection rates, utilising data from an historical Control group compared to data collected after the study intervention. In the Control group the fundal height (FH) was measured for every antenatal visit and documented in the notes, but not plotted on a chart. The study intervention used serial FH plotting on customised charts, with a dedicated clinical practice guideline and regular audits to increase clinician awareness of the intervention. RESULTS: The antenatal detection rate of SGA was 31/125 (24.8%) in the Control group and 44/87 (50.6%) in the Intervention group (P < 0.001; OR 3.10; 95% CI 1.73-5.57). CONCLUSIONS: Serial plotting of the FH on customised charts supported by a clinical practice guideline resulted in a doubling of the antenatal detection of SGA in nulliparous pregnant women at low risk for SGA.
BACKGROUND: The antenatal detection of fetal growth restriction is a focus point of antenatal care. If detected fetal demise may be prevented and perinatal complications could be managed more appropriately. AIMS: To investigate whether introducing serial plotting on customised fundal height charts can increase the detection rate of small for gestational age (SGA) fetuses in low risk nulliparous women attending antenatal clinics in a public teaching hospital in Adelaide, South Australia. METHODS: An observational study was employed to compare SGA detection rates, utilising data from an historical Control group compared to data collected after the study intervention. In the Control group the fundal height (FH) was measured for every antenatal visit and documented in the notes, but not plotted on a chart. The study intervention used serial FH plotting on customised charts, with a dedicated clinical practice guideline and regular audits to increase clinician awareness of the intervention. RESULTS: The antenatal detection rate of SGA was 31/125 (24.8%) in the Control group and 44/87 (50.6%) in the Intervention group (P < 0.001; OR 3.10; 95% CI 1.73-5.57). CONCLUSIONS: Serial plotting of the FH on customised charts supported by a clinical practice guideline resulted in a doubling of the antenatal detection of SGA in nulliparous pregnant women at low risk for SGA.
Authors: D Kabiri; R Romero; D W Gudicha; E Hernandez-Andrade; P Pacora; N Benshalom-Tirosh; D Tirosh; L Yeo; O Erez; S S Hassan; A L Tarca Journal: Ultrasound Obstet Gynecol Date: 2020-02 Impact factor: 7.299
Authors: Lesley M E McCowan; John M D Thompson; Rennae S Taylor; Philip N Baker; Robyn A North; Lucilla Poston; Claire T Roberts; Nigel A B Simpson; James J Walker; Jenny Myers; Louise C Kenny Journal: PLoS One Date: 2017-01-09 Impact factor: 3.240
Authors: Matias C Vieira; Sophie Relph; Andrew Copas; Andrew Healey; Kirstie Coxon; Alessandro Alagna; Annette Briley; Mark Johnson; Deborah A Lawlor; Christoph Lees; Neil Marlow; Lesley McCowan; Louise Page; Donald Peebles; Andrew Shennan; Baskaran Thilaganathan; Asma Khalil; Jane Sandall; Dharmintra Pasupathy Journal: Trials Date: 2019-03-04 Impact factor: 2.279
Authors: Lesley M E McCowan; John M D Thompson; Rennae S Taylor; Robyn A North; Lucilla Poston; Philip N Baker; Jenny Myers; Claire T Roberts; Gustaaf A Dekker; Nigel A B Simpson; James J Walker; Louise C Kenny Journal: PLoS One Date: 2013-08-05 Impact factor: 3.240