Fundal Height Measurement by Weeks Nursing Maternity Lecture NCLEX

Summary

This concise NCLEX-focused review explains fundal height: why we measure it (growth assessment and gestational age estimation), how to measure it (tape from symphysis pubis to uterine fundus with the patient supine—watch for hypotension), and key landmark correlations by week. After 20–36 weeks, fundal height in centimeters approximates gestational age ±2 cm; at 36 weeks it reaches the xiphoid, then regresses 4 cm as the fetus descends at 37–40 weeks. Postpartum, the fundus is at the umbilicus one hour after birth and decreases ~1 cm/day, returning to pelvic and pre-pregnancy size by ~6 weeks.

Takeaways

• 😀 Fundal height measurement is used to assess how well the baby is growing and to determine gestational age.
• 😀 The two key landmarks for measuring fundal height are the symphysis pubis (the cartilage joint between the pubic bones) and the fundus (top part of the uterus).
• 😀 The measurement is taken in centimeters from the symphysis pubis to the fundus, with the patient lying on her back.
• 😀 Be cautious of hypotension when laying the patient back, as the uterus can compress major vessels, leading to dizziness or nausea.
• 😀 After 20 weeks, the fundal height measurement should roughly match the gestational age, give or take 2 centimeters.
• 😀 At 12 weeks of pregnancy, the fundus should be just above the symphysis pubis.
• 😀 At 20 weeks, the fundus is typically at the level of the bellybutton.
• 😀 After 20 weeks, fundal height can be used to estimate the week of pregnancy, with measurements reflecting the gestational age within 2 cm.
• 😀 Around 36 weeks, the fundus reaches the xiphoid process, which may cause breathing difficulty due to lung compression.
• 😀 After 37 weeks, fundal height begins to regress as the baby drops into the pelvic cavity in preparation for birth.
• 😀 Postpartum, the fundal height starts at the bellybutton and decreases by 1 cm per day until it returns to its pre-pregnancy size, usually within 6 weeks.

Q & A

What is the purpose of measuring fundal height during pregnancy?

The purpose of measuring fundal height is to assess how well the baby is growing and to help determine gestational age.

What two anatomical landmarks are used to measure fundal height?

The two important landmarks are the symphysis pubis and the fundus of the uterus.

How should a patient be positioned when measuring fundal height, and what precaution should be taken?

The patient should be laid on her back, but care must be taken to monitor for hypotension caused by pressure on major blood vessels. Watch for signs such as dizziness, nausea, or light-headedness.

How is fundal height measured?

A tape measure is used to measure the distance from the top of the symphysis pubis to the top of the fundus in centimeters.

At about 12 weeks of pregnancy, where should the fundus be located?

At approximately 12 weeks, the fundus should be just above the symphysis pubis.

At what point in pregnancy does fundal height generally match the gestational age?

After 20 weeks of pregnancy, fundal height in centimeters typically corresponds to the number of weeks of gestation, plus or minus 2 centimeters.

Where is the fundus expected to be at around 20 weeks of pregnancy?

At 20 weeks, the fundus is usually at the level of the bellybutton (umbilicus).

At 36 weeks of pregnancy, where should the fundus be located?

At 36 weeks, the fundus is expected to reach the xiphoid process, which can cause shortness of breath due to pressure on the lungs.

Why does the fundal height decrease slightly after 37 to 40 weeks of pregnancy?

The fundal height decreases by about 4 centimeters because the baby descends into the pelvic cavity as the body prepares for birth.

Where should the fundal height be one hour after delivery?

About one hour postpartum, the fundal height should be at the level of the bellybutton.

How much does the fundal height decrease after delivery, and at what rate?

After delivery, the fundal height decreases by approximately one centimeter per day.

When should the fundus be at the level of the symphysis pubis postpartum?

The fundus should reach the level of the symphysis pubis around 7 days postpartum.

When can the uterus no longer be palpated after birth?

The uterus typically re-enters the pelvic cavity and can no longer be palpated about 10 to 14 days after delivery.

When should the uterus return to its pre-pregnancy size?

The uterus should return to its pre-pregnancy size about 6 weeks after birth.