At 20-22 weeks of gestation, the fundal height is?

Appeared in: DSSSB Public Health Nurse - 2015

Explanation

During an antenatal assessment, measuring the fundal height is a non-invasive method to estimate fetal growth and gestational age.
At 20 to 22 weeks of gestation, the uterine fundus grows to the level of the mother's umbilicus (navel).
This anatomical landmark is a reliable indicator for this stage of pregnancy, as shown in the provided image and confirmed by standard obstetric guidelines.
After 20-24 weeks, the fundal height in centimeters generally corresponds to the number of weeks of gestation (McDonald's Rule).

Option A: A fundal height between the symphysis pubis and the umbilicus is expected earlier in pregnancy.
Option B: A fundal height of 4 cm below the umbilicus indicates an earlier stage of pregnancy than 20-22 weeks.
Option D: A fundal height of 4 fingers (approximately 4 cm) above the umbilicus occurs later in the pregnancy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Fundal height measurement and its correlation with gestational age as background academic context rather than a clinical decision trigger.
The nurse's role includes accurately measuring and documenting fundal height at each antenatal visit to monitor fetal growth.
A significant discrepancy between fundal height and gestational age (more than 2-3 cm difference) can indicate potential issues such as intrauterine growth restriction (IUGR), macrosomia, multiple gestations, or incorrect dating, warranting further investigation like an ultrasound.
What if? If at 22 weeks, the fundal height measures only 17 cm (significantly below the umbilicus), the nurse should suspect potential IUGR, oligohydramnios, or a dating error. The next step would be to report this finding to the healthcare provider for further evaluation, likely including an ultrasound.

How to Approach the Question

Identify the core concept of the question: the relationship between fundal height and gestational age.
Recall or visualize the anatomical progression of the uterus during pregnancy. The uterus grows upward from the pelvis.
Focus on the specific timeframe given: 20-22 weeks.
Remember the key landmark for this period: the umbilicus (navel).
Evaluate the options based on this knowledge. The fundus is below the umbilicus before 20 weeks and above it after 22-24 weeks.
Select the option that correctly places the fundal height at the level of the umbilicus for 20-22 weeks of gestation.

Concept Tested & Keywords

Concept Tested: Fundal height measurement and its correlation with gestational age.
Stem keywords: fundal height, 20-22 weeks, gestation
Lead-in keywords: is

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E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 199-201

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 15-23

Practise the full DSSSB Public Health Nurse - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.