At 24 weeks of gestation, the fundus of the uterus is–

RML PRE 2025

Obstetrics & Gynecology

Easy

Appeared in: RML PRE 2025

Explanation

At 24 weeks of gestation, the uterine fundus has grown beyond the umbilicus.
According to McDonald's rule, from approximately 20-24 weeks gestation, the fundal height in centimeters is roughly equal to the number of weeks of gestation.
Therefore, at 24 weeks, the fundal height is approximately 24 cm, which places the top of the fundus just above the level of the umbilicus.

Option A: This landmark is typically reached at 20-22 weeks of gestation, not 24 weeks.
Option B: The fundus reaches the xiphisternum (xiphoid process) much later in pregnancy, at approximately 36 weeks.
Option C: The fundus is palpable just above the symphysis pubis much earlier in pregnancy, around 12 weeks of gestation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment of fundal height during pregnancy as background academic context rather than a clinical decision trigger.
Measuring fundal height is a non-invasive, simple, and essential part of antenatal assessment to monitor fetal growth and well-being.
A significant discrepancy between fundal height and gestational age can be an early indicator of complications such as intrauterine growth restriction (IUGR), large for gestational age (LGA) fetus, multiple gestation, or incorrect dating of the pregnancy.
What if? If at 24 weeks the fundal height measured only 20 cm, it would be a significant finding (more than 3 cm discrepancy). This would warrant further investigation, such as an ultrasound, to rule out IUGR, oligohydramnios, or an error in gestational age calculation.

How to Approach the Question

First, identify the key information in the question: the gestational age is 24 weeks, and the question asks for the location of the uterine fundus.
This is a factual recall question. Access your knowledge of normal anatomical changes during pregnancy.
Recall the typical progression of fundal height. Remember key landmarks: symphysis pubis (12 weeks), umbilicus (20-22 weeks), and xiphoid process (36 weeks).
Place 24 weeks within this timeline. It comes shortly after 20-22 weeks, so the fundus must have grown past the umbilicus.
Evaluate the options: 'At the level of umbilicus' is too early. 'At the level of xiphi sternum' is too late. 'At the level of symphysis pubis' is much too early.
Conclude that 'Above the umbilicus' is the only logical and correct position for a 24-week gestation.

Concept Tested & Keywords

Concept Tested: Assessment of fundal height during pregnancy.
Stem keywords: 24 weeks of gestation, fundus of the uterus
Lead-in keywords: BEST, MOST RELEVANT CLUE
Clinical cues: Gestational age: 24 weeks - This specific timing is the key to determining the correct anatomical landmark.
Negative lead-in flag: false

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