Prediction of gestational age with symphysis-fundal height and estimated uterine volume in a pregnancy cohort in Sylhet, Bangladesh

ObjectiveTo improve the accuracy of the prediction of gestational age (GA) before birth with the standardised measurement of symphysis-fundal height (SFH), estimation of uterine volume, and statistical modelling including maternal anthropometrics and other factors.DesignProspective pregnancy cohort study.SettingRural communities in Sylhet, Bangladesh.Participants1516 women with singleton pregnancies with early pregnancy ultrasound dating (37 weeks gestation. An estimated uterine volume (EUV) was calculated from these measures. Data on pregnancy characteristics and other maternal anthropometrics were also collected.Primary outcome measureGA at subsequent ANC visits, as defined by early ultrasound dating.Results1486 (98%) women had at least one subsequent ANC visit, 1102 (74%) women had two subsequent ANC visits, and 748 (50%) had three visits. Using the common clinical practice of approximating the GA (in weeks) with the SFH measurement (cm), SFH systematically underestimated GA in late pregnancy (mean difference −4.4 weeks, 95% limits of agreement −12.5 to 3.7). For the classification of GA