When I said:
>
><Fundal height - hmmm....don't know about that. I would like to see good
>evidence that routine fundal height measurement is clinically useful.>

Jean picked me up on that, and said fundal height is useful to highlight
possible risky situations.

I was genuinely not knowing here - not challenging! A lot of antenatal care
has just grown without any evidence that routine checks are clinically
useful - that is, we don't know if they reduce the level of pregnancy or
childbirth problems, or increase the safety of pregnancy and childbirth to
mother and/or baby.

Fundal height?  well, according to Evidence Based Clinical Guidelines,
published by the (ultra-conservative, and medically- minded) Royal College
of Obstetricians and Gynaecologists,  in their section on 'effective
procedures' , fundal height measurement is one of the issues categorised as
'no strong evidence'. I quote:

" The numbers were too small in the one study looked at in the Cochrane
Library to draw any firm conclusions.
References:

121.    Neilson JP (1995). Routine serial symphisis-fundal height
measurement. In: Enkin M W, Keirse MJNC, Renfrew M J, Neilson JP (eds).
Pregnancy and childbirth module of The Cochrane Database of Systematic
Reviews. The Cochrane Collaboration, Oxford, Update Software. "

You can check this out, with other stuff, on
http://tupac.onlinemagic.com/rcog/guidelines/eb_guidelines.html

If any of us say, in effect,    'we measure stuff in other areas of
maternity care, so maybe there's a case for test weighing'  is a
non-starter!  Especially when lots of the measurements are just done
because, well, they've always been done, with no evidence of effectiveness.

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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