Authors: Gerald Jian Ming Lee, Sze Mi Tey, Tze Keei Lim, Kar Siang Chew, Rajitha Chamath Wickrama, Malik Goonewardene.
ABSTRACT
Introduction: Inter-observer variations are one of the several limitations in the use of Symphysis-Fundal Height
(SFH) measurements which are frequently used to screen for foetal growth abnormalities prior to ultrasound foetal biometry.
Objectives: The objectives of this study are to measure the interobserver variations of SFH measurements obtained
by Semester 8 medical students of the International Medical University (IMU), Malaysia and to determine whether there is any association between maternal and observer factors and the inter-observer variations.
Method: A cross sectional study was carried out among 77 pairs of the IMU Semester 8 medical students who underwent training in the Obstetrics and Gynaecology (O&G) posting from 26th February to 31st May 2018. The first student in each pair was aware of the patient’s demographics, her gestational age (GA) and her obstetric complications if any, while the second student was blind to all the maternal data. The Limits of Agreement between the two SFH measurements obtained by a pair of students were calculated. The association between the inter observer variations in the SFH measurements obtained by a pair of students and maternal height, weight, GA, parity, body mass index (BMI) and the students’ duration of training in the O&G posting were studied.
Results: The limits of agreement between the two SFH measurements obtained by a pair of students were very wide and ranged from – 6.0 cm to + 5.6 cm. Approximately 34% of the 77 pairs of students had inter-observer variations of SFH within the clinically acceptable limit of – 2cm to +2cm. There was no association between inter-observer variations in SFH and maternal height, weight, GA, parity, body mass index (BMI) and the students’ duration of training in the O&G posting.
Conclusions: There were wide inter-observer variations between the SFH measurements obtained by IMU Semester 8 medical students but the variations were not associated with maternal or observer factors.
Keywords: Inter-observer variations, symphysio-fundal height measurements, medical students, maternal factors, observer factors.
Citation: IeJSME 2019 13(1): 15-25
