Vdm is less than normal. What should be the height of the fundus of the uterus by week of pregnancy

What should be the height of the fundus of the uterus by week

The height of the fundus of the uterus should increase by weeks of pregnancy. This is very important, because in this way the doctor, without an ultrasound scan, can say with a high degree of probability whether the fetus is developing, whether the pregnancy has frozen, whether the child is lagging behind in development, whether the amount is normal amniotic fluid etc.

The height of the fundus of the uterus by week of pregnancy is reflected in the graph, which is printed in the dispensary card of each future mother. This chart is built by a doctor or nurse who fills out the card.

Many women roughly understand the issue of the height of the fundus of the uterus by weeks of pregnancy: there is a table of average values ​​​​on our website. You should know that the average values ​​approximately coincide with the gestational age. For example, at 30 weeks, the height of the uterus will also be 30. Errors of 2-3 cm are allowed in one direction and the other. But because of them, especially if the circumference of the abdomen also grows insufficiently by weeks, many doctors prefer to play it safe and put women in a hospital for treatment in order to improve blood flow in the placenta and umbilical cord. In practice, however, these measures are ineffective.

Table of the height of the fundus of the uterus (VDM) and the circumference of the abdomen by week of pregnancy (OJ):

week of pregnancy	WDM, cm	coolant, see
12	2-6	-
16	10-18	-
20	18-24	70-75
22	20-26	72-78
24	22-27	75-80
26	24-28	77-82
28	26-32	80-85
30	28-33	82-87
32	30-33	85-90
34	32-35	87-92
36	33-38	90-95
38	36-40	92-98
40	34-38	95-100

Not all future mothers know - what is this "bottom", where is it located? It is logical to assume that below. But no, at the very top. The height of the uterus for weeks is controlled by a gynecologist. Moreover, in the first trimester, the size of the uterus is determined using a vaginal examination. And after 12-13 weeks - already without it. The woman simply lies down on the couch, and the doctor takes measurements with the help of a centimeter tape.

In the first weeks after conception, the regularly “growing” bottom of the uterus by weeks is the best proof that the pregnancy is not frozen, progressing. But of course, without special reasons, the gynecologist will not often examine his patient in the gynecological chair. One or two times is enough, in the absence of complaints of bloody discharge from the vagina.

At 20 weeks of pregnancy, the height of the fundus of the uterus almost reaches the navel. A woman feels the baby move not only at the very bottom, in the pubic area, but also from above. It depends on the strength and place where the movements are felt, in this case, on the position of the child in the uterus, which at this time is still very unstable.

Sometimes it happens that when the 20th week of pregnancy goes, the height of the uterine fundus is 2-3 centimeters lower than the average values. The woman is immediately sent for an ultrasound with a study of blood flow in the placenta and umbilical cord. The timing of this ultrasound in this case coincides with the standard screening. And often with such symptoms, fetal growth retardation and oligohydramnios are detected. Doctors say that it is precisely because of oligohydramnios that the baby has little room for movement and development. But in most cases, if the fetus does not have severe malformations, after 2-3 weeks everything returns to normal, and the baby begins to slowly catch up in size with its peers.

Thus, almost until the end of the term, 39 or even 40 weeks of pregnancy, the height of the uterine fundus continues to grow and reaches a maximum of 38 cm. Then it decreases slightly. You shouldn't be afraid of this. This phenomenon is due to the fact that the presenting part of the child, more often it is the head, sinks low into the mother's pelvis, preparing for childbirth. Therefore, the mother's tummy drops. It becomes easier for her to breathe, heartburn occurs less often. The position of the presenting part of the baby is easily determined by the gynecologist during a manual examination of the uterus on the couch, which is carried out at each visit of the expectant mother.

If the height of the fundus of the uterus at the 30-35th week of pregnancy suddenly becomes less, and the woman feels physically better, her stomach has become smaller, then this, as a rule, does not mean anything good. Perhaps the amniotic fluid has begun to break. It happens that they leak for several weeks, and the woman does not notice this. Meanwhile, this fact is a great risk of developing an infectious process in the uterus and fetal death.
Or is there a possibility premature birth. It is best to do an ultrasound: check both the amount of amniotic fluid and the readiness of the cervix for childbirth (its length, possible disclosure).

During pregnancy, a small creature grows in a woman's body. And in order to determine the correctness of its development, a lot of indicators are constantly removed. Some of them are examined every few months, on ultrasound control, others are taken every week. Those indicators that a gynecologist can take in his office without additional tests and examinations include the height of the uterine fundus. With the help of this indicator, the doctor will be able to judge the duration of pregnancy and the correct development of the fetus. Such an examination is carried out so often because VDM allows the specialist to suspect possible deviations in time and send his patient for an unscheduled ultrasound. Today we will tell you about the norms and deviations of the height of the fundus of the uterus and teach you how to take this indicator yourself.

How is the height of the uterine fundus measured and what does it depend on

As you probably already know, it is in the uterus that the development of the fetus takes place. Therefore, doctors pay special attention to this part of the female body. Since the twentieth century, the measurement of the position of the fundus of the uterus has been included in the mandatory list of measurements that a doctor must carry out during pregnancy.

Before the invention of the ultrasound machine and equipment capable of detecting hCG in the urine, gynecologists determined pregnancy precisely by the state of the uterus.

The measurement of IRR begins from the fourth month of pregnancy. It is at this time that the uterus reaches such a size that its height can be checked without interfering with the vagina.

That indicator of the position of the uterus can be felt on its own. To do this, you will need a regular centimeter tape, although doctors use special device.

To measure the height of the bottom of the uterus, you need to lay the pregnant woman on her back. Next, a measurement is made of the distance from the pubic symphysis (the beginning of the pubis) to the bottom of the uterus (the upper point of the abdomen).

The height of the uterine fundus is important for assessing the vital activity of the fetus. If any abnormalities occur, abnormalities during pregnancy can be suspected, which helps to choose the right tactics for further management.

Using the data on the circumference of the abdomen and the height of the fundus of the uterus, we can assume the weight of the fetus.

Several formulas are used to calculate:

• Calculation according to Yakubova: (OJ (cm) + VDM (cm)) / 4 * 100
• According to Jordania: OD (cm) × WDM (cm)
• According to Lankowitz: (woman's height (cm) + body weight (kg) + coolant (cm) + WDM (cm)) * 10
• According to Johnson: (WDM -11) * 155
• According to Bublichenko: 1/20 * body weight (kg)

At 26-28 weeks, the weight of the fetus is 1.000 grams, at 36 weeks it is about 2.500 grams and by the 40th week of pregnancy it reaches 3.300 grams.

How to measure the height of the fundus of the uterus?

After registration for pregnancy, weight, blood pressure, heart rate are checked. From the second trimester, they begin to determine the height of the fundus of the uterus, the circumference of the abdomen, listen to the fetal heartbeat.

Measurements are carried out lying on the couch, after freeing the stomach from clothes. A centimeter tape is applied to the upper edge of the pubic joint, and the edge of the palm of the other hand leads the tape up the abdomen to the highest point of the fundus of the uterus. Then the centimeter tape is transferred to the level of the navel and the circumference of the abdomen is measured.

At the end of the appointment, all the data are indicated in the pregnant woman’s card, which allows you to evaluate the changes and conduct an examination on time.

The height of the fundus of the uterus by week of pregnancy: table

From early pregnancy to the end of the first trimester, the doctor conducts an examination on the gynecological chair. The size of the uterus varies, depending on the period. By the 6th week it resembles a large chicken egg, by 8 weeks it resembles a goose egg, by the 9th week it resembles a woman's fist, by 10-11 weeks a man's fist, and by the 12th week of pregnancy the uterus increases to the size of a newborn's head and determined at the edge of the pubic arch.

As soon as the bottom of the uterus rises above the womb, the size of the body of the uterus can be determined through the abdominal wall.

The table shows the norms of the height of the fundus of the uterus:

Obstetrics:		The height of the fundus of the uterus:
months	weeks	(cm)	distance
			middle between symphysis and umbilicus
			two fingers below the navel
			at the level of the umbilicus
			into two transverse fingers above the navel
			at the xiphoid process
			middle between the umbilicus and the xiphoid process of the sternum

As can be seen from the table, in the 9th month, the fundus of the uterus reaches its maximum rise. Usually, 2 weeks before giving birth, women feel that their stomach has dropped and it has become easier to breathe.

At multiple pregnancy figures exceed the standards by 4 cm or more. So, for example, at 5 months, the height of the fundus of the uterus can reach 17 cm.

The height of the fundus of the uterus does not correspond to the gestational age: reasons

The characteristics of the body of the expectant mother or an erroneous definition can affect the indicators of the height of the fundus of the uterus.

But changes can also indicate a pathological process:

The height of the uterine fundus is greater than the gestational age:

• polyhydramnios, accompanied by excessive production of amniotic fluid, the volume of which can be 1.5 liters or more. Unfortunately, with polyhydramnios, spontaneous abortion often occurs;
• with a post-term pregnancy or diabetes mellitus, they are often diagnosed;
• when the size of the pelvis of a woman and the head of the fetus do not match, then they speak of the presence of a narrow pelvis. The head remains mobile over the entrance, which is the cause of premature rupture of amniotic fluid.

The bottom of the uterus may be below the expected gestational age:

• transverse or oblique position of the fetus;
• chronic placental insufficiency, followed by intrauterine growth retardation and fetal development;
• oligohydramnios, when there are violations in the secretion, resorption and exchange of amniotic fluid, the amount of which does not reach even 500 ml. In most cases, this type of pathology indicates serious violations of the fetus.

To correctly determine the gestational age, other indicators are also evaluated:

• the date of the last menstruation, when two weeks later from the first day of menstruation, the countdown begins;
• from the 18th week, a woman begins to feel fetal movements, if this is not the first birth, and around the 20th week of pregnancy, they appear in nulliparous;
• Ultrasound provides the most accurate results.

Find out why the analysis is important and how to take it!

Vladlena Razmeritsa, obstetrician-gynecologist, specially for the site

Useful video

An important diagnostic indicator in the management of pregnancy is the height of the fundus of the uterus. The discrepancy between the height of the uterine fundus (FHH) and the gestational age may indicate the development of pathology and requires additional diagnostic measures.

What is VSDM? Where is the uterine fundus located in women who have not given birth? What is the normal size of the uterus during pregnancy? Should a pregnant woman be worried if the height does not match the table?

How is the uterus arranged?

The main function of the uterus is childbearing. The organ is made up of tight muscular joints, thanks to which it can stretch to the desired size as the fetus grows and contract to natural size in the postpartum period.

During pregnancy, this little pouch of elastic muscles expands almost 500 times. The weight of the uterus before pregnancy is only 50 g, and at the 40th week this figure reaches 1–1.5 kg.

Where is the uterine fundus located before pregnancy?

Many women are interested in where the uterine fundus is located. This is the highest point protruding above the pubic joint. In a woman who has not given birth, the length of the uterus is approximately 7 cm. As soon as a fertilized egg is introduced into its mucosa, its size begins to gradually increase. On early term the bottom is located slightly below the navel and rises as the organ grows with the baby inside. The determination is made in two stages:

• external manual examination of the uterus;
• measurement of the circumference of the abdomen and VDM using a centimeter tape.

External palpation of the fundus of the uterus becomes possible only from the 16th week of pregnancy (for more details, see the article: the size of the uterus at the 16th week of pregnancy). Until this time, VDM can only be determined by vaginal examination.

How does the uterus change during pregnancy?

The change in the size and shape of the uterus is due to the growth of the baby in it. Since the baby weighs more every week, the uterus, accordingly, also stretches more. Approximately until the 3rd month, the uterus is at the level of the womb. In size and shape, it resembles a chicken egg, and a little later a goose egg. At this time, the tummy is not yet growing, so nothing can betray the woman's condition.

Before the third trimester of pregnancy, the uterus becomes ovoid. After 32-34 weeks, the baby inside the uterus should take a natural prenatal position - head down.

Changes are also experienced by the structure of the tissues of the uterus. The walls during this period become thicker and a powerful vascular network forms on them.

How and why is the height of the uterine fundus determined?

Data on the height of the uterus is mandatory entered into the patient's exchange card after each scheduled and unscheduled visit. Before the appointment, the expectant mother needs to prepare for the examination, for example, empty the intestines in a timely manner. An overfilled bladder can also distort the real values ​​of UMR. In addition, a pregnant patient should carefully consider the outfit. The future mother should choose comfortable and free things. It is better for patients to refuse clothes that squeeze the stomach or are difficult to remove. Each scheduled inspection usually proceeds as follows:

• the adoption by a woman of a horizontal position;
• palpation of the uterus;
• determination of the length from the pubic bone to the upper part of the uterus using a tape meter.

Despite the fact that the procedure takes less than 1 minute, it is very informative. Usually, after fixing the height of the fundus of the uterus, the obstetrician measures the circumference of the abdomen in order to determine the estimated volume of amniotic fluid. These measurements are less accurate than WDM, as they depend on the thickness of the fat layer on the abdominal wall and the individual characteristics of the woman's physique. In accordance with the gestational age, the gynecologist draws conclusions about the development, position of the fetus and the amount of amniotic fluid.

A woman can independently find out where the bottom of the uterus is located at home. To do this, you need to lie down, attach a centimeter tape from the pubic joint to the point at which the stomach ceases to be hard. This length is the SRDM.

Norm and pathology: table of values ​​​​of VSD

The table below shows the values ​​of the standing height of the uterine fundus normal and critical indicators. Deviations from the norm by 1-2 cm should not disturb a pregnant woman. If the measurement results are among the critical ones, the gynecologist is obliged to refer the patient for additional diagnostics - ultrasound, dopplerometry, cardiotocography.

What is the deviation from the norm?

The specialist leading the pregnancy relies not only on the parameter of the circumference of the abdomen and measurements of the VDM. If you suspect the development of pathology, these indicators allow you to assess the condition of the child and act proactively. The advantage of the method is its painlessness and speed of implementation.

Indicators less than the norm may indicate both problems and features of the anatomy of the expectant mother. So, short stature, the narrow hips of the expectant mother may affect the results of the measurement of UMD.

Deviation from the standard indicators may indicate an erroneous determination of the gestational age. If the pregnancy proceeds without complications and complaints of deterioration in well-being, a low indicator is a sign that the gynecologist incorrectly calculated the week of pregnancy. Errors in determining the period occur due to irregular periods or in the case when a woman does not remember exactly the date of the last menstruation.

Another reason is the pathology of growth and development of the fetus. The deviation of the VDM from the norm may indicate various disorders of the course of pregnancy, for example, oligohydramnios.

In some pregnant women, the WDM indicator, on the contrary, is overestimated. It is less dangerous for the pregnant woman and her baby. Indicators above the norm are a sign of:

• Large build child. In most cases, the excess of the indicator is due to a hereditary factor. In rare cases, a deviation from the norm is a manifestation of diabetes mellitus in the mother or intrauterine pathologies.
• Multiple pregnancy. Several babies develop in the uterus. In rare cases, two fetuses may be placed in such a way that the first ultrasound detects only one child.
• The physique of the patient. The height of the fundus of the uterus in a tall woman with massive hips may slightly exceed the normal figure.
• Incorrect intrauterine position of the fetus. This often happens in the third trimester. Since a planned ultrasound is performed at 32–34 weeks, and a baby up to 40 weeks can change its position several more times, measuring the VDM is the only way to determine its location without ultrasound
• Violations of the course of pregnancy. Too high standing of the fundus of the uterus on later dates considered a sign of polyhydramnios. A higher than normal indicator may also indicate a dangerous pathology - the presence of chorionepithelioma, that is, a tumor in the tissue of the placenta.