Where would the Fundal height be located in a pregnant client at 16 weeks gestation?
|
Show Illustration of fundal height at various points during pregnancy Fundal height, or McDonald's rule, is a measure of the size of the uterus used to assess fetal growth and development during pregnancy. It is measured from the top of the mother's uterus to the top of the mother's pubic symphysis. Fundal height, when expressed in centimeters, roughly corresponds to gestational age in weeks between 16 and 36 weeks for a vertex fetus. When a tape measure is unavailable, finger widths are used to estimate centimeter (week) distances from a corresponding anatomical landmark. However, landmark distances from the pubic symphysis are highly variable depending on body type. In clinical practice, recording the actual fundal height measurement from the palpable top of the uterus to the superior edge of the pubic symphysis is standard practice beginning around 20 weeks gestation. Most caregivers will record their patient's fundal height on every prenatal visit. Measuring the fundal height can be an indicator of proper fetal growth[1] and amniotic fluid development. Knowledge of gestational age may impact how the height is measured.[2] Fundal height landmarks[edit]
Shorter measure[edit]A shorter measure can happen for one of the following reasons:
Longer measure[edit]On the other side, a longer measure can be caused by:
As a pregnancy approaches its end, the fundal height will become less accurate. Symphysiofundal height is more accurate at 14–32 weeks. References[edit]
Feeling/measuring your belly, listening to babyFeeling your abdomenFeeling the pregnant belly is part of every antenatal visit after 12 weeks of pregnancy. The medical term for this is “abdominal palpation”. The aim of it is to monitor the growth and position of your baby. It does not hurt the baby. From 12 to 20 weeks The main aim of abdominal palpation is just to ensure that the uterus is growing.
From 20 to 34 weeks The baby is big enough to feel where the head is. Unborn babies change position frequently during this phase of pregnancy and are quite often in a breech position (bottom down) or lying across your belly in a transverse position. The size of your uterus should be approximately relevant to how far pregnant you are. Many caregivers use fundal height measurements as part of monitoring the baby’s growth during this phase of pregnancy. From 34 to 37 weeks The baby is more than likely in a head down position. Your caregiver feels for your baby’s head and perhaps detects which side of your belly their back is laying on (right or left). Babies at this stage do not usually move their head from being down now because their head is much larger and heavier, but their back can move frequently from one side of your belly to the other. The uterus reaches the base of your breast bone or sternum by about 36 to 37 weeks. The fundal height measurements become irrelevant after 35 to 36 weeks. From 37 weeks to birth Your baby should definitely be head down now. Your caregiver feels your baby’s head and tries to determine if it has engaged yet. The baby’s head can engage anytime from 1 to 4 weeks before the birth. Although it is normal for some women’s babies not to engage until they start labouring, especially if it is a second or subsequent baby. If your baby’s head engages, the fundal height usually drops lower, although fundal measurements are not generally used during the final weeks of pregnancy. Measuring fundal heightStudies have shown some benefit in doing fundal height (FH) measurements. However, caregivers concede it is not always reliable and we don’t really have any technique that is more than 50% accurate. Bearing this in mind, it is important to view fundal heights as just a guide, with very limited ability in detecting unusually small or large babies. Even ultrasound in estimation of baby’s weight has been shown to be up to 10 to 15% out, or ± 400 to 600 grams. Measuring FH involves the woman lying down (it is not meant to be donein a standing or sitting position) and her caregiver placing the end of the measuring tape on her pubic bone. The symphysis pubis bone is situated just below the pubic hair line. The length of tape is then positioned up the middle of the woman’s belly with the measurement taken from where the tape reaches the top of her uterus or fundus, giving a fundal height in centimetres (cm). Fundal heights tend to be used from 24 to 37 weeks of pregnancy. A text book fundal height is supposed to equal the same amount of weeks as the pregnancy. For example, 24 weeks pregnant equal 24 cm and so forth (up until about 36 to 37 weeks). However, fundal height measurements can fluctuate 2 to 4 cm higher or lower than the expected norm. Most caregivers are reasonably happy if your measurement is consistently lower or higher at each visit (for example 22 cm at 24 weeks and then 26 cm at 28 weeks). However, they may be concerned if you measured at 24cm at 24 weeks and only 25cm at 28 weeks, because the baby has not demonstrated much of a progressive growth over the four weeks. Listening to your babyAn unborn baby’s heart rate changes as they grow:
An unborn baby’s heart beat can sound a little like a horse galloping. A hand held Doppler machine can detect baby’s heart beat from about 12 to 14 weeks of pregnancy, although this is not always possible. It is definitely detectable from about 16 to 18 weeks of pregnancy. Ultrasounds can detect baby’s heart beat from around 7 to 8 weeks of pregnancy (possibly as early as 6 weeks in some cases). Essentially, the head of the Doppler machine is placed on the woman’s belly with conducting gel (similar to gel used in regular ultrasounds), which helps the machine pick up the baby’s heart beat. The machine is then switched on and the caregiver tries to angle it in the best possible way to detect the baby’s heart beat. This may require a little bit of pressure as they gently push the Doppler into your belly. It may take a minute or so to find your baby’s heart beat, especially if the pregnancy is very early (less than 18 weeks) or your baby is lying in an awkward position or is very active. You may also hear other noises through the machine:
If there is any concern, a continuous monitoring with CTG machine for 20 minutes or more is indicated. Your queries are best answered over the phone, our friendly reception staff would be happy to assist you with your enquiry, contact us on +02 8824 4998 Book an Appointment Where is the fundal height at 16 weeks?Your fundal height measurement changes as your pregnancy progresses. Here's a range of typical fundal height measurements during pregnancy: At 12 weeks, the fundus is at the level of the pubic bone. At 16 weeks, it's about halfway between the pubic bone and the belly button (the umbilicus).
What should fundal height be at 17 weeks?At 17 weeks, baby measures just over 5 1/4 inches (13.5 centimeters) when measured from the top of their head to the bottom of their buttocks (crown-rump length).
Where is fundal height at 15 weeks?Fundal height is the distance between the top of the uterus and pubic bone. Typically, the fundal height will measure (in centimeters) the same as the week of pregnancy — the 15th week would equal 15 centimeters.
What is the fundal height at 18 weeks?So right now, your fundal height is probably about 18 centimeters. This measure helps your provider gauge fetal growth.
|
