The following examples illustrate some of the main concepts in the use of customised charts.
SGA – small for gestational age
FGR – fetal growth restriction
SFH – standardised fundal height (measured from fundus to symphysis)
EFW – estimated fetal weight, by ultrasound
GROW – gestation related optimal weight (customised charts)
GAP – growth assessment protocol
A first SFH measurement above the 90th centile itself is not an indication for referral, as it usually does not reflect a large baby. The most important indicator is whether subsequent measurements will show normal accelerated growth (see next).
This chart demonstrates a normal pattern of growth. Women should be reassured that fundal height measurements are of the uterus and all its contents. They are not meant to predict the size or weight of the baby, but to assess with serial measurements that it is growing well. An individual fundal height measurement above the 90th centile does not require referral for scan, unless there are other concerns e.g. polyhydramnios, or accelerated growth (see next slide).