Overview
Serial fundal height measurement is a simple, inexpensive, and non-invasive screening method for assessing fetal growth, widely accepted by mothers.
Preparation and Consent
- Explain the procedure to the mother and obtain her informed consent.
- Ensure the mother has an empty bladder, as a full bladder can add 2–3 cm to the measurement.
Positioning the Mother
- Position the mother on a firm couch or mattress in a semi-reclined position.
- If a firm surface is unavailable, have her lie on the floor, with pillows supporting her head and shoulders.
Palpation and Landmarks
- Perform a two-handed abdominal palpation to determine fetal lie, presentation, and position.
- Locate the highest point of the fundus and the top of the symphysis pubis.
- Note that the fundus may not always be in the midline due to uterine or fetal positioning.
Measuring Procedure
- Keep one hand on the highest point of the fundus and secure the zero end of a non-elastic tape measure there.
- Measure in a straight line from the fundus to the top of the symphysis pubis.
- Perform the measurement only once to avoid introducing bias.
Documentation and Follow-Up
- Record the measurement on the mother’s customized growth chart.
- If the measurement deviates from the normal growth curve, refer the mother for an ultrasound to estimate fetal weight.
Action Items
- TBD – Practitioner: Refer mothers with abnormal fundal height curves for an ultrasound scan to estimate fetal weight.