By which week is the height of pregnant uterus at the level of the umbilicus?

Appeared in: AIIMS Delhi NO - 2017

Explanation

At 24 weeks of gestation, the fundus of the uterus is expected to be at the level of the umbilicus.
This is a standard anatomical landmark used in obstetrics to track fetal growth and confirm gestational age.
While there can be minor variations, 24 weeks is the most widely accepted milestone for the fundus reaching the umbilicus.

Option A: At 20 weeks, the fundal height is typically 1 to 2 finger breadths below the umbilicus, not at the level of the umbilicus.
Option C: At 16 weeks, the fundus is much lower, located midway between the symphysis pubis and the umbilicus.
Option D: At 28 weeks, the fundus has already grown past the umbilicus and is located about one-third of the distance between the umbilicus and the xiphoid process.

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 crucial, non-invasive part of every antenatal check-up to monitor fetal growth.
A fundal height that is significantly smaller or larger than expected for the gestational age can indicate potential problems such as intrauterine growth restriction (IUGR), macrosomia, multiple gestation, or incorrect dating of the pregnancy.
After 20-24 weeks, the fundal height in centimeters should roughly equal the number of weeks of gestation (McDonald's Rule). For example, at 26 weeks, the fundal height should be approximately 26 cm.

How to Approach the Question

This is a factual recall question based on standard obstetric knowledge.
First, identify the key anatomical landmark mentioned in the question: 'level of the umbilicus'.
Next, recall the established timeline of uterine growth during pregnancy.
Mentally (or by sketching) map the fundal height progression: symphysis pubis (12 weeks) -> midway to umbilicus (16 weeks) -> umbilicus (20-24 weeks) -> xiphoid process (36 weeks).
Compare the options provided. Both 20 and 24 weeks are close. Recall the more precise landmark: 20 weeks is often just below the umbilicus, while 24 weeks is considered at the level of the umbilicus.
Select the option that most accurately corresponds to the landmark. In this case, 24 weeks is the most precise answer.

Concept Tested & Keywords

Concept Tested: Assessment of fundal height during pregnancy.
Stem keywords: pregnant uterus, height, level of the umbilicus
Lead-in keywords: By which week
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur pp. 50-60, 15-23

Practise the full AIIMS Delhi NO - 2017

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