- With Mayo Clinic obstetrician and medical editor-in-chief
Roger W. Harms, M.D.
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Roger W. Harms, M.D.
Roger W. Harms, M.D.
"Nothing helps people stay healthy more than the power of real knowledge about health." — Dr. Roger Harms
As medical editor-in-chief, Dr. Roger Harms is excited about the potential for MayoClinic.com to help educate people about their health and provide them the tools and information to live healthier lives.
The Auburn, Neb., native has been with Mayo Clinic since 1981 and is board certified in obstetrics and gynecology. Dr. Harms is a consultant and associate professor of obstetrics and gynecology, and his specialty areas include office gynecology, high-risk obstetrics and obstetrical ultrasound.
From 2002 to 2007, Dr. Harms was director for education for Mayo Clinic, Rochester, Minn. Dr. Harms was the 1988 Mayo Medical School Teacher of the Year and served as associate dean for student affairs and academic affairs before taking this leadership role. He is the co-author of the "Mayo Clinic Model of Education." In 2008, Dr. Harms was presented the Distinguished Educator Award, Mayo Clinic, Rochester.
Dr. Harms is vice chair of the Department of Obstetrics & Gynecology and medical editor of the Pregnancy section on this Web site. In addition, Dr. Harms is editor-in-chief of the "Mayo Clinic Guide to a Healthy Pregnancy" book, a month-by-month guide to everything a woman needs to know about having a baby.
"My medical education experience has grown out of a love of teaching, and that is what this site is about," Dr. Harms says. "If any visitor to this site makes a more informed and thus more comfortable decision about his or her health because of the information we provide, we are successful."
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Second trimester (1)
- Fundal height: An accurate indicator of fetal growth?
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Question
Fundal height: An accurate indicator of fetal growth?
I'm 27 weeks pregnant. My doctor says I'm measuring at 29 weeks. What does this mean? How accurate is fundal height?
Answer
from Roger W. Harms, M.D.
Fundal height is the distance from the top of the uterus to the pubic bone measured in centimeters. Starting in the second trimester, fundal height usually matches closely to the number of weeks you've been pregnant. For example, if you're 27 weeks pregnant, your health care provider would expect your fundal height to be about 27 centimeters. However, the measurement has a wide range of normal findings.
Larger than expected fundal height
A fundal height 2 centimeters larger than expected isn't usually cause for concern. This degree of variance isn't unusual and can be caused by many harmless factors, such as:
- A thicker than average uterus or abdominal wall
- A full bladder
- Scarring from a prior C-section
- Short stature
- Twins or other multiples
If your fundal height continues to increase faster than expected, your health care provider may recommend an ultrasound or other tests to determine what's causing the unusual measurements. Possible causes may include:
- Rapid fetal growth (macrosomia) due to gestational diabetes
- Excessive amniotic fluid (polyhydramnios), which may indicate a problem with the baby or the pregnancy
- Uterine fibroids, which can increase the risk of miscarriage, preterm birth and breech birth
Smaller than expected fundal height
It's also common to have a fundal height that's a few centimeters smaller than expected. Like a larger than expected fundal height, this degree of variance can be caused by many harmless factors, such as:
- A tall or slim frame
- Well-conditioned abdominal muscles
- A baby prematurely descending into the pelvis
If fundal height measures much smaller than expected throughout pregnancy or increases more slowly than expected, a health care provider may suspect:
- Intrauterine growth restriction, a condition that slows a baby's growth
- Too little amniotic fluid (oligohydramnios), which may indicate a problem with the baby or the pregnancy
- A baby in a breech position
As with a larger than expected fundal height, an ultrasound or other tests are typically done to determine what's causing the unusual measurements.
Next questionEarly miscarriage: Is stress a factor?
- Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2007:1.
- Low birthweight. March of Dimes. http://search.marchofdimes.com/cgi-bin/MsmGo.exe?grab_id=6&page_id=12451840&query=intrauterine+growth&hiword=GROWTHS+growth+intrauterine+. Accessed March 16, 2009.
- What's inside. March of Dimes. http://search.marchofdimes.com/cgi-bin/MsmGo.exe?grab_id=6&page_id=1987584&query=macrosomia&hiword=MACROSOMIC+macrosomia+. Accessed March 16, 2009.
- Katz VL. Prenatal care. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008:13.
- Uterine fibroids. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp074.cfm. Accessed March 18, 2009.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. March 18, 2009.
- Kahn BF, et al. Intrauterine growth restriction. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008:199.
