Standing of the bottom of the uterus by weeks. The height of the fundus of the uterus (VDM) and its dynamics by weeks of pregnancy. Possible reasons for the deviation of the WDM values from the norm

In the body of a woman during pregnancy, there are serious changes that allow her to endure and give birth to a baby. According to such changes, doctors determine how well the pregnancy is proceeding, the fetus is developing. One of the main indicators of the condition of a woman and a child is the height of the uterine fundus during pregnancy. Of great diagnostic importance is the determination of the height of the uterine fundus by weeks of pregnancy. Consider what the term “bottom of the uterus during pregnancy” means, why it is determined, what are its normal values.

Why determine the height of the bottom of the uterus during pregnancy

The female uterus is a unique organ that is able to stretch during pregnancy and return to its original size after childbirth. The uterus consists of a larger part (body) located on top and a smaller part (cervix) located below. The isthmus connects the body and the cervix. The bottom of the uterus is the highest part of the body of this organ.

The wall of the uterus consists of the following layers:

internal (endometrium),
middle (myometrium),
external (perimetry).

The myometrium, or muscular membrane, makes up the bulk of the walls of the uterus. It is due to changes in the myometrium that the size of the uterus increases during pregnancy. By the middle of pregnancy, the walls of the uterus thicken up to 3-4 cm, due to the division of muscle cells of the myometrium. Then the size of the uterus increases only due to stretching and thinning of its walls. In the last weeks of pregnancy, the thickness of the walls of the uterus is 0.5-1 cm.

In a woman of reproductive age outside of pregnancy, the length of the uterus is 7-8 cm. By the end of pregnancy, the uterus reaches a length of 37-38 cm. At the same time, in the case of multiple pregnancies, polyhydramnios, it can reach even larger sizes.

The increase in the uterus during pregnancy begins at 5-6 weeks. First of all, the uterus becomes larger in the anteroposterior size, then in the transverse. At the eighth week of pregnancy, the size of the uterus is doubled, at the tenth week - three times, at the twelfth - four times.

In the second trimester of pregnancy (13-14 weeks), the woman's uterus extends beyond the small pelvis. An obstetrician-gynecologist at this time can already feel it through the anterior abdominal wall. It is at this time that the doctor begins to measure the height of the fundus of the uterus during pregnancy (FH).

The height of the uterine fundus during pregnancy is affected by the amount of amniotic fluid, the size and position of the baby. The bottom of the uterus will be higher with twins, a large fetus, polyhydramnios, since in such cases the uterus stretches more. At the same time, the height of the fundus of the uterus in different women differs by 2-4 cm, due to individual characteristics.

This indicator is determined starting from the 16th week of pregnancy at each visit by a woman to a consultation. To do this, the expectant mother lies on the couch with straightened legs and the doctor measures the VDM with a centimeter tape. It is best if the woman empties her bladder first. Thanks to this study, the doctor can judge the development of the child, his position, the amount of amniotic fluid.

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

There are generally accepted values of the normal WDM, which depend on the duration of pregnancy. At the same time, such values are not absolute, deviations from them can vary within 3-4 cm. Obstetricians pay more attention to the rate of increase in the value of VDM relative to the previous one.

Here are the values of the norm of the height of the fundus of the uterus by week of pregnancy:

8-9 weeks - 8-9 cm; the size of the uterus corresponds to the size of a goose egg, it is still impossible to probe through the wall of the peritoneum;
10-13 weeks - 10-11 cm;
14-15 weeks - 12-13 cm;
16-17 weeks - 14-18 cm;
18-19 weeks - 16-20 cm;
20-21 weeks - 18-23 cm; finding the bottom of the uterus is projected two fingers below the navel;
22-23 weeks - 21-26 cm;
24-25 weeks - 23-27 cm; the bottom of the uterus is located in the navel of a woman;
28 weeks - 28 cm; the bottom of the uterus is conditionally projected two fingers above the navel;
29-30 weeks - about 31 cm;
32 weeks - 32 cm; the uterus is located in the middle of the conditional line between the navel and the xiphoid process of the sternum;
36 weeks - 35-37 cm; the bottom of the uterus is located on the line connecting both costal arches;
38 weeks - 35-38 cm; after this period, the uterus begins to descend;
40 weeks - 32-34 cm; the bottom of the uterus is again located between the navel and the ribs.

With a normal pregnancy, a woman usually does not feel the growth of the uterus. After all, this process occurs gradually and smoothly. Sometimes at the beginning of pregnancy, the expectant mother may notice certain unusual sensations that are associated with a change (softening) in the structure of the uterine ligaments. Pain during an increase in the uterus occurs in the following conditions:

multiple pregnancy;
polyhydramnios;
anatomical deviation of the uterus backwards;
adhesive process in the abdominal cavity;
the presence of a scar on the uterus after surgery.

Possible reasons for the deviation of the WDM values from the norm

As mentioned above, in different women, the values of the WDM may differ slightly from the accepted norms. But in some cases, such deviations can be significant. What is it connected with?

There are certain reasons leading to the fact that the height of the uterine fundus during pregnancy is much higher than normal:

large fruit;
multiple pregnancy;
polyhydramnios;
narrow pelvis of a woman;
abnormal position of the fetus in the uterus.

The value of VDM is significantly below the norm in the following cases.

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.

With multiple pregnancies, the numbers 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

The size of the uterus during pregnancy by week (table): why the size does not correspond to the terms

According to the dynamic development of the uterus, and the height of its bottom, the doctor evaluates the successful course of pregnancy. How to correctly measure the changing dimensions of an organ? What deviations affect the increase? What to do if there is a threat of miscarriage?

The uterus of a nulliparous woman has a very modest size: 5.0 - 6.0 cm in length; 3.4 - 4, 0 - wide. Its weight is about 50 gr. For 9 months of gestation, the organ undergoes huge, increasing in size, thinning, reaching a weight together with the fetus up to 4 kg. This transformation, recorded weekly in a special table of indicators, is the dynamic course of pregnancy.

Leopold measurements
- The height of the fundus of the uterus in the early stages
- When can an organ be measured?
Uterine parameters during pregnancy
- Thickness of the uterine wall
- Location
- Dimensions for anatomical defects
Gradual change of the uterus during pregnancy
- The size of the uterus by week
- When can you feel the uterus yourself
- Neck dimensions in the table
- Normal size of the uterus by week of pregnancy in the table
- What can affect the height of the uterine fundus
- Changes in the uterus with multiple pregnancy
Techniques to support a thin uterus or emaciated cervix with the threat of preterm labor
Why the size of the uterus does not correspond to the term

Method for measuring the uterus during pregnancy

The measurement is carried out using the "Leopold technique" - a special obstetric technique.

Measurement is carried out with an empty bladder.
The woman lies on her back, on the couch.
Rising with a hand from the pubic region along the midline of the abdomen, the area where the dense tissue becomes soft and loose is groped - this is the border of the uterus, called the bottom.
A soft ruler measures the distance from the pubic bone to the bottom.

With physiologically correct development, the distance in centimeters coincides with the period established in weeks. Possible error: 1 - 2 cm. This calculation is applicable up to 37 - 38 weeks. Later, the uterus settles into the pelvic cavity, preparing for childbirth.

Is it possible to take measurements in the early period?

Norm table for the cervix

The change undergoes not only the uterine cavity, but also the cervix. From the moment of conception, it lengthens, softens, changes color. Its length reaches 4.0–4.5 cm. In the future, a gradual shortening of the canal is noted.

The following parameters indicate the successful development of pregnancy.

Important! Rapid shortening of the neck is a threat to full gestation. Such progress is especially dangerous for a period up to.

WDM norm table - uterine fundus height

The fundal height of the uterus is measured weekly, starting at 14 weeks. The data is recorded in the patient's individual table to monitor the dynamics. Physiologically normal pregnancy corresponds to the following indicators.

Why is the uterus out of date?

The height of the fundus of the uterus does not always correspond to the designated period. Deviations can be significant, although the date of conception is set correctly. Why does this situation arise?

Placental insufficiency leads to a delay in the formation of the embryo, as a result - to a reduced dynamics. This condition leads to the presence, prolonged exhausting toxicosis, severe.

The opposite situation is the increased size of the uterus in relation to the time of gestation. A common diagnosis is an increased amount of amniotic fluid. It occurs as a result of infection with an intrauterine infection (herpes, and others). It is noticed that polyhydramnios occurs in women with a history of surgical or spontaneous abortion.

With a dynamically developing pregnancy, the upper border of the uterus fits into the weekly norms allotted to it, reflected in the table. But if deviations occur, do not panic, the discrepancy with the accepted indicators does not yet indicate the pathology of the fetus. There are many reasons why the size of the uterus exceeds or does not reach the norm. It is necessary to conduct an examination, and adjust the timing and condition.

Actual video

When does the belly start to grow during pregnancy?

The biggest changes that occur in the female body during pregnancy are probably associated with her uterus. It is here that a fertilized egg is normally attached for its further growth and development. To provide the growing fetus with the space it needs to live, the uterus is constantly growing in size. In the process of growth, it rises higher and higher, reaching a maximum at about 37 weeks of gestation.

The size of the uterus and the height of its standing are of great diagnostic value. They help to determine the approximate duration of pregnancy and draw conclusions about its course, as well as assess the degree of development and size of the fetus and identify probable deviations in time. That is why the gynecologist will examine and evaluate the size and height of the uterus at each examination of his ward.

In the early stages, the size of the uterus is determined by finger probing through the vagina. But from the second trimester, after about 13-14 weeks, the uterus goes beyond the border of the pelvic region, rising higher, and it can already be felt through the abdominal wall. Now the gynecologist will each time take her measurements, or rather, the height of the bottom.

The standing height of the bottom of the uterus () is the distance between the top point of the pubic symphysis and the highest point of the uterus, which is its bottom. It is measured in centimeters in the position of a pregnant woman, lying on her back, using a special tazometer device or a regular centimeter tape. Each time the doctor enters all the indicators into yours in order to be able to compare them and track the dynamics.

To evaluate the indicators, a table is used that shows the norms for the compliance of the VDM with the gestational age:

As you can see, the height of the uterine fundus in centimeters approximately corresponds to the gestational age in weeks, plus or minus 2-3 cm. This range of fluctuations in the values of the VMD takes into account the individual characteristics of each pregnant woman, in particular, her physiological parameters.

A significant discrepancy between the height of the uterine fundus and the norms at a particular stage of pregnancy gives the doctor reason to suspect something was wrong. With inflated rates, we can talk about or too much. Underestimated VDM indicators may indicate a low rate of fetal development, its transverse or oblique location.

However, do not rush to panic and draw premature conclusions if your fundal height does not correspond to the deadline. First, often the cause of differences is an error in determining the gestational age. Secondly, in the case of overestimated indicators, the reason can be doubly pleasant - this is development. Thirdly, indicators of the height of the fundus of the uterus are not very informative in themselves. It is necessary to evaluate the dynamics, and if from week to week or from month to month the uterus rises higher and higher, as expected, then there is most likely no reason to worry. However, if there is a suspicion of any violation, the doctor will refer you to additional studies (ultrasound, dopplerometry, CTG, and others), and this should not be neglected.

Also note that 2-4 weeks before the onset of labor, the baby begins to descend into the pelvis, which we call. At the same time, the uterus also decreases slightly and the VDM accordingly decreases by several centimeters, which can also be seen in the table.

Especially for- Elena Kichak

Standing of the bottom of the uterus by weeks. The height of the fundus of the uterus (VDM) and its dynamics by weeks of pregnancy. Possible reasons for the deviation of the WDM values ​​from the norm