Symphysis_Fundal_Height_Flashcards
What is the symphysis-fundal height (SFH)?
The SFH is measured from the top of the pubic bone to the top of the uterus in centimetres.
What should the SFH match after 20 weeks of gestation?
The SFH should match the gestational age in weeks to within 2 cm after 20 weeks, e.g., if 24 weeks then a normal SFH = 22 to 26 cm.
summarise
Symphysis-fundal height
The symphysis-fundal height (SFH) is measured from the top of the pubic bone to the top of the uterus in centimetres
It should match the gestational age in weeks to within 2 cm after 20 weeks, e.g. if 24 weeks then the a normal SFH = 22 to 26 cm
A pregnant woman presents for review. She is 24 weeks pregnant. What would be the expected symphysis-fundal height?
13 - 15 cm
15 - 17 cm
17 - 19 cm
18 - 22 cm
22 - 26 cm
22 - 26 cm
After 20 weeks, symphysis-fundal height in cm = gestation in weeks
The correct answer is 22 - 26 cm. Symphysis-fundal height (SFH) is a measure of the size of the uterus used to assess fetal growth and development. It is measured from the pubic symphysis to the top of the uterus (the fundus). In centimetres, it should roughly equal the gestational age in weeks after 20 weeks of gestation, hence at 24 weeks, it should be around 24 cm, but with a generally acceptable range between 22 - 26 cm.
13 - 15 cm would be too small for a pregnancy at this gestational age. This could suggest intrauterine growth restriction or other complications such as oligohydramnios or placental insufficiency which are conditions where there’s not enough amniotic fluid or the placenta isn’t functioning properly.
15 - 17 cm, similar to above, is also below the expected SFH for a woman who is 24 weeks pregnant. Again, this could indicate potential issues with fetal growth and would warrant further investigation.
A measurement of 17 - 19 cm, while closer to what might be expected, is still lower than usual for this stage of pregnancy. It may suggest that the fetus is smaller than average for its gestational age.
Finally, 18 - 22 cm, although closer to what we would expect at this stage, it’s still on the lower end. This could potentially indicate that further assessment may be needed if coupled with other concerning signs or symptoms.
Your next patient in an antenatal clinic is a woman who is 30 weeks pregnant. Which of the following findings during your examination would you be concerned with?
Fundus palapable above the umbilicus but below the xiphisternum
Fundal height growth of 2cm per week
Breech presentation
Able to auscultate the foetal heart
Free head on palpation
The correct answer here is a fundal height growth of 2cm per week. After 24 weeks you would only expect the fundal height to increase by 1cm a week. You would, therefore, be concerned that either there is an unknown multiple pregnancy or the baby is big for dates and further investigations should be carried out.
You would expect the fundus to be palpable at the umbilicus from 20 weeks and at the xiphoid sternum from 36 weeks.
You would expect the head to be free on palpation until about 37 weeks in a nulliparous woman, but often in multiparous women, the head engages just before labour starts.
Breech presentation is common before 34 weeks and only becomes a concern in women who go into preterm labour
