Measurement of fundal height

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Fundal height measurement is a common method for assessing fetal growth during pregnancy.
• Current methods often rely on comparing the uterine fundus to anatomical landmarks on the maternal abdomen.

Purpose of the Study:

• To evaluate the accuracy and reliability of using anatomical landmarks for fundal height assessment.
• To identify limitations associated with traditional fundal height measurement techniques.

Main Methods:

• Review of existing literature on fundal height measurement techniques.
• Analysis of biological variability in anatomical landmark placement.
• Assessment of inter-observer reliability among clinicians.

Main Results:

• Inability to accurately assess fundal growth using finger breadths or fractional distances between landmarks.
• Significant biological variability in anatomical landmark placement.
• Disagreement among experts regarding the fundus-to-landmark relationship at various gestational stages.
• Variability in the gestational week when the fundus reaches the umbilicus among different women.

Conclusions:

• A rational basis for using anatomical landmarks to assess fundal height does not exist.
• Inexpensive and more accurate techniques for measuring fundal growth are available and recommended.