hecklist for Gestational Age Estimation
Abdominal Examination, Correct Estimation of Gestational Age
S. No. Task
1. Note:
• It is important that abdominal examination during pregnancy be
done with an empty bladder. Ask the woman to empty her
bladder.
• Give the woman a clean bottle and ask her to collect a little urine
in the bottle before emptying her bladder completely. The urine
will be required later to test for sugar and proteins.
• Maintain privacy and obtain the woman’s verbal consent.
2. Help the woman lie comfortably on her back, supported by cushions
or pillows, on the examination table. Ask her to loosen her clothes
and uncover her abdomen.
3. Check the abdomen for any scars. If there is a scar, find out if it is
from a caesarean section or any other uterine surgery.
4. Fundal Height
a. Ask the woman to keep her legs straight.
b Measuring Fundal Height
To estimate the gestational age through the fundal height, the
abdomen is divided into parts by imaginary lines. The most
important line is the one passing through the umbilicus. Then divide
the lower abdomen (below the umbilicus) into three parts, with two
equidistant lines between the symphysis pubis and the umbilicus.
Similarly, divide the upper abdomen into three parts, again with two
imaginary equidistant lines, between the umbilicus and the
xiphisternum.
At 12th week- Just palpable above the symphysis pubis
At 16th week- At lower one-third of the distance between the
symphysis pubis and umbilicus
At 20th week- At two-thirds of the distance between the symphysis
pubis and umbilicus
At 24th week- At the level of the umbilicus
At 28th week- At lower one-third of the distance between the
umbilicus and xiphisternum
At 32nd week- At two-third of the distance between the umbilicus and
xiphisternum
At 36th week- At the level of the xiphisternum
At 40th week- Sinks back to the level of the 32nd week, but the flanks
are full, unlike that in the 32nd week.
c. Measuring FH (in cms) using Measuring Tape
i. Place the ulnar (media/inner) border of the hand on the
woman’s abdomen starting from the xiphisternum (the lower
end of the sternum/breastbone), and gradually proceed
downwards towards the symphysis pubis lifting your hand
between each step down, till you finally feel a bulge/resistance,
which is the uterine fundus. Mark the level of the fundus.
ii. - Using a measuring tape, measure the distance (in cm) from
the upper border of the symphysis pubis along the uterine
curvature to the top of the fundus.
- This is the fundal height. Note it down in the Mother and
Child Protection Card
- After 24 weeks of gestation, the fundal height (in cm)
corresponds to the gestational age in weeks (within 1-2 cm
deviation).
Note: When measuring the fundal height, the woman’s legs should
be kept straight and not flexed.
