Fundal height measures for IUGR often unreliable. (Sensitivity of 70%).

SAN FRANCISCO -- The most routine screening method for intrauterine growth restriction is also the least reliable, Dr. Robin Field said at a meeting on antepartum and intrapartum management sponsored by the University of California, San Francisco.

Studies show that fundal height measurement--usually a routine part of prenatal care--has a sensitivity of only 70% for intrauterine growth restriction (IUGR), said Dr. Field, director of perinatal services at Kaiser Permanente Medical Center in San Francisco.

"In real clinical practice, it probably misdiagnoses IUGR about 50% of the time. It's an important test to arouse our suspicions. And if you are suspicious that you have IUGR, you go on to the next step," he said.

Most experts accept fetal abdominal circumference as the most reliable measurement of fetal size. An abdominal circumference within the normal range reliably excludes IUGR with a false negative rate of less than 10%, according to studies. Animal studies show that abdominal circumference at the liver is actually an indirect measure of the nutritional status of the fetus. The liver is the most affected organ in IUGR.

...