Fundal height

measurement
Fundal height measurement

➢ is an important part of maternity nursing.

➢ By measuring the fundal height during pregnancy, we
can determine how well the baby is growing and
gestational age.

❑ To measure the fundal height, the patient will need to

lie down on their back.

❑ You will then use a tape measure to measure from the

symphysis pubis to the fundus.
 Key Concepts about Fundal Height:

➢ The fundal height is above the symphysis

pubis at 12 weeks. It is at the belly button
(navel or umbilicus) at 20 weeks.

➢ At 36 weeks it measures at the xiphoid

process,

➢ and then at 37-40 weeks the fundus

regresses downward about 4 cm from the
xiphoid process.
❑ After pregnancy (1 hour after delivery),
the fundus is at the umbilicus.

❑ It will decrease 1 cm per day and be non-

palpable by 10-14 days.

❑ By day 7, it will be at the symphysis pubis.

❑ After 20 – 36 weeks fundal height will

reflect weekes of pregnancy + or – 2cm
❑ 1. Where should be the Fundus be at about 12 weeks of
pregnancy?

❑ A mother is 26 weeks pregnant where would you expect

that fundal height to be?

(It can be anywhere in between 24 cm to 28 cm)

 Naegele’s Rule

Ruth A. Ambon RN, RM, MAN

NCM107
Lyceum of the Philippines University - Cavite
 This maternity lecture will help you learn
how to calculate an estimated delivery date
(EDD)
using Nagele's Rule.

❑Naegele's rule works best for women who

have a 28 day cycle and is based on the
typical 280 day gestation (40 weeks) period.

❑The date calculated with Naegele's Rule is

just an estimate for expected delivery date.
❑ When solving for an EDD with Nagele's Rule it
is important to remember the months that have
30 (thirty) days vs. 31 (thirty-one) days,

❑ and of course, February has 28 days. Always give

February 28 days (regardless of leap year) to
avoid confusion.

❑ The months with 30 days are September, April,

June, and November while the other months
are 31 days.
Subtract 3 months
Add 7 days to LMP
Add 1 year
-------------------------------
EDD

(best when LMP – April to

December)
OR

Add 7 days to LMP

Add 9 months
-----------------------------
EDD

Best when LMP –

January to March
 Nagel’s Rule Practice
Questions

1. Last Menstrual Period: May 21,

2016

2. Last Menstrual Period:

November 25, 2016
3. Last Menstrual Period:
January 20, 2016

4. Last Menstrual Period:

March 14, 2016
5. Last Menstrual Period:
August 28, 2016

6. Last Menstrual Period:

August 15, 2016
7. Last Menstrual Period:
January 30, 2016
 Answer Key:

1. February 28, 2017

2. September 1, 2017

3. October 27, 2016

4. December 21, 2016

5. June 4, 2017

6. November 6, 2016
 GTPAL

Ruth A. Ambon RN, RM, MAN

NCM107
Lyceum of the Philippines University - Cavite
 GTPAL is an acronym that
stands for:

Gravida
Term births
Preterm births
Abortions
Living

- An acronym used to assess

pregnancy outcomes
 Gravidity:

number of times the woman has been

pregnant

THIS INCLUDES CURRENT

PREGNANCY
MISCARRIAGES
ABORTIONS
and *twins/triplets count as one
 Term Births:

number born (alive or stillborn)

at 37 weeks gestation onward
(*twins/triplets count as one)
 Preterm births:

number born 20-37 weeks

(alive or stillborn)

twins/triplets counts as one

Includes alive or still born
 Abortion/Miscarriages:

pregnancy losses before 20 weeks

(counts as a pregnancy…so would
put in gravidity as well)

** if baby died after 20 weeks it is added

under preterm or term not abortion.
- Preterm
- Twins and triplets (count as one)
 Living children:

number of children living

(NOTE: twin/triplets counts
individually)
Sample:

A 26 year old female is 26 weeks

pregnant. She has a
miscarriage at 10 weeks
gestation 5 years ago. She has 3
year old who was born at 39
weeks. What is her GTPAL?
Answer:

G–3
T–1
P–0
A–1
L–1
1. A 30 year old female is 25 weeks pregnant with twins.
She has 5 living children. Four of the 5 children
were born at 39 weeks gestation and one child was
born at 27 weeks gestation. Two years ago she had a
miscarriage at 10 weeks gestation. What is her GTPAL?

2. A 27 year old female is currently 16 weeks pregnant.

She has 2 year-old twins that were born at 37 weeks
gestation and a 5 year-old who was born at 40 weeks
gestation. She had no history of miscarriage or
abortion. What is her GTPAL?
3. A 20 year old female is currently 8
weeks pregnant. She had a miscarriage
at 32 weeks gestation two years ago. She
has no living children. What is her
GTPAL?

4. A 26 year old female is currently 26

weeks pregnant. She had a miscarriage
at 10 weeks gestation five years ago. She
has a three year old who was born at 39
weeks. What is her GTPAL?
5. A 35 year old female is currently pregnant
with twins. She has 10 year old triplets who were
born at 32 weeks gestation, and a 16 year old who
was born at 41 week gestation. Twelve years ago
she had a miscarriage at 29 weeks gestation. What
is her GTPAL?

6. A 39 year old female is currently 18 weeks

pregnant. She has two sets of twin daughters
that were born at 38 and 39 weeks gestation and
an 11 year-old son who was born at 32 weeks
gestation. She has no history of miscarriage or
abortion. What is her GTPAL?
7. A 29 year old female is currently 9 weeks
pregnant. She has no living children. Two years
ago she had 2 miscarriages at 10 and 12 weeks
gestation, and 9 months ago a miscarriage at 36
weeks gestation. What is her GTPAL?

8. A 30 year old female is 20 weeks pregnant with

twins. She has a 6 year-old who was born at 40
weeks gestation. She has no history of
miscarriage or abortion. What is her GTPAL?
 Answer Key:

1. G=7, T=4, P=1, A=1, L=5

2. G=3, T=1, P=0, A=0, L=3

3. G=2, T=0, P=1, A=1, L=0

4. G=3, T=1, P=0, A=1, L=1

5. G=4, T=1, P=2, A=1, L=4

6. G=4, T=2, P=1, A=0, L=5

7. G=4, T=0, P=1, A=3, L=0

8. G=2, T=1, P=0, A=0, L=1