WOMEN AND NEWBORN HEALTH SERVICE
King Edward Memorial Hospital
DPMS
Ref: 5269 All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual Page 1 of 2
CLINICAL GUIDELINES
SECTION B : OBSTETRICS AND MIDWIFERY CARE
1 ANTEPARUM CARE
1.6 ANTEPARTUM PROCEDURES - MATERNAL
Date Issued: November 2001 1.6.3 Measuring Fundal Height with a Tape Measure
Date Revised: September 2012 Section B
Review Date: September 2015 Clinical Guidelines
Authorised by: OGCCU King Edward Memorial Hospital
Review Team: OGCCU Perth Western Australia
Key words: fundal height measurement
1.6.3 MEASURING FUNDAL HEIGHT WITH A TAPE MEASURE
AIMS
To determine the gestation and growth of the fetus.
To identify multiple pregnancies and complications of pregnancy e.g. amniotic fluid disorders,
hydatidiform mole, and fetal growth disturbances.
BACKGROUND INFORMATION
Measuring fundal height has been shown to be more accurate for detecting a small-for-gestation fetus
than performing palpation alone.1 Symphysis-fundal height (SFH) measurement refers to the distance
measured in centimetres on the longitudinal axis of the abdomen from the top of the fundus to the
upper border of the symphysis pubis. A measurement discrepancy of more than 2cm can be
suggestive of a fetus that is small/large for gestational age, multiple pregnancy, or an inaccurate
estimated due date.2 Other causes include molar pregnancies, polyhydramnios/oligohydramnios, an
oblique or transverse lie.1 Between 20 to 34 weeks gestation the height of the uterus correlates
closely with measurements in centimetres, however obesity has been shown to distort the accuracy of
these measurements3. Also towards the end of pregnancy measurements become less accurate due
to the descent of the fetal presenting part into the maternal pelvis.2
PROCEDURE
ADDITIONAL INFORMATION
1 Obtain maternal consent.
2 Encourage the woman to empty her bladder
if she has not done so in the last 30 minutes. It has been demonstrated the fundal height
can be 3 cm higher at 17-20 weeks gestation
if the woman has a full bladder.3
3 Position the woman in a supine position with
her legs extended. While not the preferred position for most
women, a supine position has been found to
yield least variation in measurements.4
Consider placing a wedge under the right
buttock if the gravid uterus is of a size likely
to compromise maternal and/or fetal
circulation.
An enlarged uterus can compress the inferior
vena cava and the lower aorta leading to
maternal supine hypotension and reduced
utero-placental blood flow which can cause
fetal compromise.5
