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KCE reports vol. 6A Prenatale zorg 61
3. Fundal height measurement
What is the detection rate of a fundal height measurement?
Study Ref Population Intervention Outcomes Results Comments Study
Gardosi
and
Francis,
1999
4 [567] 1272 consecutive
women with singleton
pregnancies booked
before 22 weeks from
1995 to 1995
4. Leopold manoeuvres
Fundal height measurement plotted on
customised charts (n = 734) vs. fundal
height assessment by abdominal palpation
and recorded on standard cooperation
card (n = 605
Detection of small-
and large-forgestational-age
babies (SGA and
LGA)
Number of
referrals for
investigations
SGA: 47.9% vs.
29.2%, OR 2.23,
95%CI 1.12 to 4.45
LGA: 45.7% vs.
24.2%, OR 2.63,
95% CI 1.27 to
5.45
Referrals for
investigations in
pregnancy
assessment centre:
0.33 vs. 0.56 visits
per pregnancy, p <
0.005
What is the sensitivity, specificity and negative predictive value of the Leopold manoeuvres?
Study Ref Population Intervention Outcomes Results Comments Study
Thorp et
al., 1999
5 154 pregnant women
in the perinatal
ultrasound clinic at the
University of North
Carolina Hospitals
from July 1989 to July
Prospective test of Leopold
maneuvers as a screen of
nonvertex presentation in
the third trimester, using
ultrasound as the gold
standard
Sensitivity
Specificity
Positive predictive value
28%
94%
24%
Prevalence of noncephalic
presentation is 7%
Possible underestimation of
the validity of this test as a
screen for malpresentations:
EL
type
CSNR 2a
EL
type
TES 3