FUNDAL HEIGHT: MEASURING

WITH A TAPE MEASURE

• A fundal height measurement is typically done to
determine if a baby is small for its gestational age.
• The measurement is generally defined as the
distance in centimeters from the pubic bone to the
top of the uterus.
• The expectation is that after week 24 of pregnancy
the fundal height for a normally growing baby will
match the number of weeks of pregnancy — plus
or minus 2 centimeters. For example, if you're 27
weeks pregnant, your health care provider would
expect your fundal height to be about 27
centimeters.
• A fundal height measurement might be less accurate,
however, if you have a body mass index of 30 or
higher (obesity) or have a history of fibroids.
• Depending on the circumstances, your health care
provider might recommend an ultrasound to
determine what's causing the unusual measurements
or more closely monitor your pregnancy.
• But fundal height is only a tool for gauging fetal
growth — it's not an exact science. And further
research is needed to determine how effective it is
in detecting intrauterine growth restriction.
Typically, fundal height measurements offer
reassurance of a baby's steady growth. If you're
concerned about your fundal height measurements,
ask your health care provider for details.
 AIMS

• Slow fetal growth (intrauterine growth restriction)

• A multiple pregnancy
• A significantly larger than average baby (fetal
macrosomia)
• Too little amniotic fluid (oligohydramnios)
• Too much amniotic fluid (polyhydramnios)
 PROCEDURE

• Obtain maternal consent.

• Encourage the woman to empty her bladder if she
has not done so in the last 30 minutes. It has been
demonstrated the fundal height can be 3 cm higher
at 17-20 weeks gestation if the woman has a full
bladder.
• Position the woman in a supine
position with her legs extended.
While not the preferred position
for most women, a supine
position has been found to yield
least variation in measurements.
• Consider placing a wedge under the right buttock
if the gravid uterus is of a size likely to
compromise maternal and/or fetal circulation. An
enlarged uterus can compress the inferior vena
cava and the lower aorta leading to maternal
supine hypotension and reduced utero-placental
blood flow which can cause fetal compromise.
 • Ensure hands are clean and warm. Warm hands
minimize maternal discomfort and potential for inducing
contraction of the uterus.
• Position one end of the tape measure at the notch of
symphysis pubis. Pull the tape measure up and over the
woman’s abdomen to the top of the fundus, being
careful not to tip the corpus of the fundus
• To locate the fundus the hand is moved down the
abdomen below the xiphisternum until the curved
upper border of the fundus is felt.
• Measure the distance in centimeters.