Fundal height at the 28th week of gestation will be -

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

McDonald's rule is a common method for estimating gestational age by measuring the height of the uterine fundus.
From approximately 20 to 36 weeks of gestation, the fundal height in centimeters should roughly equal the number of weeks of gestation.
A normal variation of plus or minus 2 cm is considered acceptable.
For a 28-week gestation, the expected fundal height is 28 cm.
The acceptable normal range is therefore 26 cm to 30 cm (28 ± 2 cm).
Among the given options, 30 cm is the only value that falls within this expected range.

Option A: A fundal height of 22 cm is significantly lower than expected for 28 weeks of gestation.
Option C: A fundal height of 36 cm is significantly higher than expected for 28 weeks of gestation.
Option D: A fundal height of 40 cm is markedly high for 28 weeks and would suggest a potential complication.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Estimation of gestational age using fundal height measurement (McDonald's Rule) as background academic context rather than a clinical decision trigger.
Fundal height measurement is a simple, non-invasive, and cost-effective screening tool used in antenatal care to monitor fetal growth and well-being.
A measurement that is smaller or larger than expected for the gestational age can be an early indicator of potential problems, such as intrauterine growth restriction (IUGR), fetal macrosomia, incorrect dating, multiple gestation, or abnormal amniotic fluid volume.
Consistent and accurate measurement is crucial. The nurse should use a standardized technique, measuring from the superior border of the symphysis pubis to the top of the uterine fundus.

How to Approach the Question

First, identify the key information in the question: 'fundal height' and '28th week of gestation'.
Recall the principle for estimating gestational age using fundal height, which is McDonald's rule.
Apply McDonald's rule: Fundal height (in cm) ≈ Gestational age (in weeks) ± 2 cm.
Calculate the expected range for 28 weeks: 28 cm ± 2 cm, which gives a range of 26 cm to 30 cm.
Evaluate each option to see which one falls within the calculated normal range.
Select the option that fits the criteria. In this case, 30 cm is the only value within the 26-30 cm range.

Concept Tested & Keywords

Concept Tested: Estimation of gestational age using fundal height measurement (McDonald's Rule).
Stem keywords: Fundal height, 28th week, gestation
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

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