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((More citations needed|date=December 2009))
[[File:Fundal height by gestational age.jpg|thumb|right|Illustration of fundal height at various points during pregnancy]]

'''Fundal height''', or '''McDonald's rule''', is a measure of the size of the [[uterus]] used to assess [[Gestational age (obstetrics)|fetal growth]] and development during [[pregnancy]]. It is measured from the top of the mother's uterus to the top of the mother's pubic symphysis. Fundal height, when expressed in centimeters, roughly corresponds to gestational age in weeks between 16 and 36 weeks for a vertex fetus. When a tape measure is unavailable, finger widths are used to estimate centimeter (week) distances from a corresponding anatomical landmark. However, landmark distances from the pubic symphysis are highly variable depending on body type. In clinical practice, recording the actual fundal height measurement from the palpable top of the uterus to the superior edge of the pubic symphysis is standard practice beginning around 20 weeks gestation.

Most caregivers will record their patient's fundal height on every prenatal visit. Measuring the fundal height can be an indicator of proper fetal growth<ref name="pmid19914874">((cite journal |vauthors=Morse K, Williams A, Gardosi J |title=Fetal growth screening by fundal height measurement |journal=Best Pract Res Clin Obstet Gynaecol |volume=23 |issue=6 |pages=809–18 |date=December 2009 |pmid=19914874 |doi=10.1016/j.bpobgyn.2009.09.004 ))</ref> and amniotic fluid development.

Knowledge of gestational age may impact how the height is measured.<ref name="pmid17906025">((cite journal |vauthors=Jelks A, Cifuentes R, Ross MG |title=Clinician bias in fundal height measurement |journal=Obstet Gynecol |volume=110 |issue=4 |pages=892–9 |date=October 2007 |pmid=17906025 |doi=10.1097/01.AOG.0000282758.28533.d9 |s2cid=31769249 ))</ref>

==Fundal height landmarks==
{|class="wikitable" align="center"
! [[Gestational age (obstetrics)|Gestational age]] !! Fundal height landmark
|-
| 12–14 weeks || [[Pubic symphysis]]
|-
|16 Weeks   || [[Between Umbilicus and pubic symphysis]]
|
|-
| 20–22 weeks || [[Navel|Umbilicus]]
|-
| 36 weeks || [[Xiphoid process]] of sternum
|-
| 37–40 weeks || Regression of fundal height between 36 and 32&nbsp;cm
|}

==Shorter measure==
A shorter measure can happen for one of the following reasons:
*Fetus descent into the pelvis, seen normally two to four weeks before delivery
*Error in estimated date of pregnancy based on first day of last menstrual period
*Fetus is healthy but physically small
*[[Oligohydramnios]]
*Non longitudinal lie
*[[Small for gestational age]] or [[Intrauterine Growth Restriction]]

==Longer measure==
On the other side, a longer measure can be caused by:
*[[Twins]], or other types of [[multiple births]]
*Error in estimated date of conception
*Fetus is healthy but physically large
*[[Gestational diabetes]] causing a larger baby
*[[Polyhydramnios]]
*[[Large for gestational age]]
*[[Hydatidiform Mole]]
*[[Breech birth]]

As a [[pregnancy]] approaches its end, the fundal height will become less accurate.                      
Symphysiofundal height is more accurate at 14–32 weeks.

==References==
((reflist))

((Pregnancy))

((DEFAULTSORT:Fundal height))
[[Category:Obstetrics]]
[[Category:Midwifery]]

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