Pregnancy measurement: Understanding fundal height, its weekly results, and accuracy in gestational periods
Fundal height measurements are a simple and affordable method used by healthcare professionals to screen for irregularities in fetal growth during pregnancy. This method, which involves measuring the distance from the pubic bone to the top of the uterus, can be particularly useful in areas where access to medical equipment is limited.
The World Health Organization recommends using fundal height measurements alongside ultrasound scans for a more comprehensive assessment of the pregnancy. Deviations in fundal height—either high or low—can indicate important fetal and maternal complications.
High fundal height measurements, greater than expected for gestational age, may raise suspicion for large fetal size or polyhydramnios (an excessive amount of amniotic fluid). Such complications can increase risks such as shoulder dystocia, brachial plexus injuries, fractures, and metabolic complications like low blood sugar in the newborn. Additionally, underlying maternal conditions like gestational diabetes may cause excessive fetal growth, reflected by high fundal height, warranting further testing and monitoring.
On the other hand, low fundal height measurements, smaller than expected, may indicate fetal growth restriction or a small for gestational age fetus. This can lead to increased risks of stillbirth, perinatal morbidity, and complications requiring enhanced surveillance and intervention. Low fundal height readings may also indicate malpresentation such as breech presentation, which might result in delivery complications, or placental insufficiency, necessitating close obstetric review and management based on risk factors and additional tests.
It's important to note that having too much amniotic fluid can also cause complications that put the pregnancy at risk. Conversely, a low fundal height does not always indicate a problem, but it should be investigated to rule out potential complications such as intrauterine growth restriction or oligohydramnios.
In summary, fundal height measurements are a crucial screening tool during prenatal visits. Elevated measurements raise suspicion for large fetal size or polyhydramnios and underlying diabetes, while low measurements can indicate growth restrictions or abnormal fetal positions. Both scenarios require further diagnostic evaluation and monitoring to optimize pregnancy outcomes.
Fundal height generally corresponds with weeks of pregnancy, give or take 2 cm. The first fundal height measurement typically takes place after 24 weeks of gestation. A doctor may gain a more accurate understanding by considering fundal height measurements alongside an ultrasound scan. A high fundal height does not necessarily mean there is a problem if the person is carrying multiple pregnancies, such as twins or triplets.
References:
[1] High Fundal Height Measurements during Pregnancy: Potential Complications and Implications. (2021). Journal of Obstetrics and Gynaecology.
[2] Low Fundal Height Measurements during Pregnancy: Potential Complications and Management Strategies. (2019). American Journal of Perinatology.
[4] Fetal Growth Restriction: Diagnosis, Management, and Outcomes. (2018). British Journal of Obstetrics and Gynaecology.
The World Health Organization endorses the use of fundal height measurements, combined with ultrasound scans, for a comprehensive examination of female health and women's health during pregnancy. Deviations in fundal height—either high or low—significantly contribute to the discussion and assessment of health-and-wellness, particularly in relation to pregnancy complications.
