EXAMPLE:

FUNDIC HEIGHT IS 21 CMS

21 CMS X 8 =168

168/ 7 = 24 ( AOG I N WEEKS)

Fundic H eight

Typically, the distance from the fundus

to the symphysis in centimeters is
equal to the week of gestation between
the 20th and 31st weeks of pregnancy.

M EA S U R IN G
FU N D IC H EIG H T

 Measure from the notch

of the symphysis pubis

to over the top of the
uterine fundus as the
woman lies supine.
Place the zero line of the
tape measure on the
anterior border of the
symphysis pubis and
stretch tape over
midline of abdomen to
top of fundus.
The tape should be
brought over the curve
of the fundus

c. BARTHOLOMEWS
RULE
estimation of AOG
by the relative
position of the uterus
(fundus) in the
abdominal cavity.

12 weeks at the level of the

symphysis pubis
16 weeks halfway between
symphysis pubis and
umbilicus
20weeks at the level of the
umbilicus
24 weeks two fingers above
umbilicus
30 weeks midway between
umbilicus and xiphoid process
36 weeks at the level of
xiphoid process

EFW (ESTIM ATED FETAL

W EIG H T)
JOHNSONS RULE:
Needs fundic height measure in cm
If unengaged:
EFW in g = (FH 11) x 155
If engaged:

EFW in g = (FH -12) x 155

EFL(ESTIM ATED FETAL LEN G TH

IN CM
HAASES RULE
First five months of pregnancy: square the month
To square the month is to multiply it by itself:
Example: How long is a three-month-old fetus?

3 x 3 = 9cm
For the second half of pregnancy:
Multiply month by 5
Example : How long is a 7-month-old fetus
7 x 5 = 35 cm

Fetalheart rate
FHR should be 120-

160
beats per minute

Can be heard with a

Doppler : 10 12th
week of pregnancy
( 3 months)

Fetoscope: 18-20

weeks
( 4 months)
Regular Stethoscope:
20 weeks ( 5 months)

LO CATIN G FETAL H EART SO UN D S BY FETAL PO SITIO N

FH T heard bestatthe FETAL BACK

FetalM ovem ent

Sandovsky Method
Ask woman to lie in Left Recumbent

Position after a meal

Record how many fetal movements she
feels over the next hour
Fetus normally moves a minimum of
twice every 10 minutes or 10-12 times
an hour

 Cardiff Method( Count-to-Ten)

Woman records the time interval it takes

for her to feel 10 fetal movements

Usually occurs within 60 minutes

Lungs
Assess respiratory rate and rhythm
Feel short of breath due to less
diaphragmatic excursion(diahragm
movement)

BACK
Assess spine for abnormal curve that

would suggest scoliosis

RECTUM
Assess for hemorrhoids due to uterine

pressure on pelvic veins

EXTREMITIES AND SKIN

Palmar erythema or itching early in

pregnancy from a high estrogen level

Subclinical jaundice due to reabsorbed
bilirubin because of slowed intestinal
peristalsis
Assess lower extremities for varicosities
Assess for edema due to impaired
venous return from lower extremities
Assess gait(waddling gait late in
pregnancy from relaxation of the

InternalExam ination
Detects early signs of pregnancy
Chadwicks,Goodells, Hegars sign

Preparation for IE:

1. Explain procedure
2. Void before IE
3. Proper Positioning: Lithotomy
4. Draping
5. Instructions: position hands across the

chest; correct breathing, slow, chest

Important concerns of Physical

examinations:
Breast changes
Fundic height
Pelvic measurements: done in the 3rd
trimester to determine
CPD(cephalopelvic disproportions
Extremities:
Discomforts: leg cramps, varicosities,

pedal edema
Danger sign: + Homans sign (pain in
the calf upon dorsiflexion of the toes; a
sign of thrombophlebitis)

Leopolds M aneuver

3.PO ST CO N SULTATIO N PH ASE = H EALTH

TEACH IN G S

Nutrition
Bathing
Breast care
Perineal Hygiene
Dental care
Exercises
Clothing
Traveling
Employment
Sexual relations