Fundal height at the 24th week of pregnancy is ?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2022

Obstetrics and Midwifery Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2022

Explanation

At 24 weeks of gestation, the top of the uterus (fundus) grows to the level of the mother's umbilicus (belly button).
This is a standard and reliable anatomical landmark used in antenatal care to track fetal growth.
According to McDonald's rule, from approximately 22 to 36 weeks, the fundal height measured in centimeters should roughly equal the gestational age in weeks, plus or minus 2 cm.
Therefore, at 24 weeks, a measurement of around 24 cm from the symphysis pubis to the fundus, which aligns with the level of the umbilicus, is expected.

Option A: The fundus reaches the xiphisternum (the lowest part of the sternum) much later in pregnancy.
Option C: This position is higher than the umbilicus and is reached later than 24 weeks.
Option D: This position is below the umbilicus and is reached earlier than 24 weeks.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment of gestational age using fundal height measurement as background academic context rather than a clinical decision trigger.
Fundal height measurement is a fundamental, non-invasive, and cost-effective screening tool to assess fetal growth and well-being during pregnancy.
A significant discrepancy (greater than 2-3 cm) between the measured fundal height and the expected gestational age can indicate potential issues such as Intrauterine Growth Restriction (IUGR), macrosomia (large baby), multiple gestation, or incorrect dating of the pregnancy, prompting further investigation with ultrasound.
Consistent and accurate measurement technique is vital for reliable tracking. The nurse should ensure the patient's bladder is empty and she is positioned correctly (supine with knees slightly flexed) to get an accurate reading.

How to Approach the Question

This is a factual recall question that tests your knowledge of key milestones in pregnancy.
First, identify the core concept being tested: the relationship between gestational age and fundal height.
Recall the standard anatomical landmarks for uterine growth during pregnancy (symphysis pubis, umbilicus, xiphisternum).
Mentally map the progression: The fundus starts low at the symphysis pubis (12 weeks), reaches the umbilicus around the middle of the pregnancy, and ascends towards the xiphisternum near term.
Specifically recall or deduce the landmark for 24 weeks, which is a well-known midpoint: the umbilicus.
Evaluate each option against this knowledge. Eliminate options that correspond to earlier or later stages of pregnancy.

Concept Tested & Keywords

QCGPsw5328JBqm68_PbtkG

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

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