The height of the fundus of the uterus above the womb. How is the position of the fundus of the uterus determined during pregnancy, what is the norm of the height of its standing by weeks? What is WMD during pregnancy

At each visit of a pregnant woman to the doctor leading her pregnancy, the height of the uterine fundus is measured. In the exchange card, the doctor designates this parameter as VDM or VSM. What is such a measurement, why is it carried out and how does this height change throughout the entire period of the intrauterine life of the baby, this article will tell.

What it is?

The female reproductive organ, which becomes a safe haven for a growing child throughout pregnancy, resembles a bag. Its lower part is like the knotted part of this bag, it is the narrowest. This is the cervix, which is a round muscle. The widest part of the uterus, domed, is called the fundus of the uterus. The word “bottom” should not be embarrassing, because for a growing baby who will leave the womb during childbirth, this domed part will really be the bottom. The inlet to the outlet inside the reproductive organ is one - this is the cervical canal inside the cervix, and it is located below.

The height of the bottom of the uterus is a special size that reflects the height to which the bottom has risen relative to the pubis. Until the end of the first trimester, the parameters of the uterus are small (by the eighth week - no more than a goose egg), and it fits perfectly in the space of the small pelvis.

But the genital organ grows rapidly, the number of muscle fibers increases, and by the start of the second trimester, the uterus ceases to fit in the small pelvis and goes beyond it, into the abdominal cavity, gradually rising up and propping up the diaphragm. It is for these good reasons that the belly grows, its visual increase in a woman who is preparing for imminent motherhood.

Fundal height shows how much its growth corresponds to the gestational age, and to a certain extent this size indicates that is everything in order with the lady “in position” and her child. That is why, at each visit to the consultation during all months of pregnancy, starting from 12–14 weeks, the doctor measures the VMD (VSD) and the circumference (girth) of the belly of the expectant mother along the navel line. By the ratio of these two values, using obstetric formulas, it is even possible to calculate the estimated weight of the fetus. Until a certain time, while ultrasound did not exist, this was the only way to find out whether a woman was to give birth to a large, normal or miniature baby.

Today, experts pay less attention to VSM than before, because there are much more diagnostic tools at the disposal of the obstetrician, and their accuracy is much higher. But this parameter was not completely removed from the protocols of the Ministry of Health and obstetric practice in pregnant women.

The definition of VDM can be carried out both independently and with the help of an obstetrician-gynecologist. It is not difficult.

Measurement technique

The actual term of the "interesting position" according to the state of the uterus, doctors set earlier, before the genital organ rises from the small pelvis. In the first trimester of pregnancy, palpation is used for this purpose - a bimanual method of gynecological examination (one hand is inserted into the genital tract, and the other is pressed on the lower abdomen to determine the boundaries of the organ). You can't feel anything outside. This method does not provide very accurate information, but an experienced obstetrician can establish pregnancy with a two-handed method with an accuracy of up to a week.

To measure how much the bottom of the uterus has risen, you can use a centimeter tape, a tazomer, as well as the width of the fingers located transversely. It is acceptable to determine the VSDM by anatomical landmarks.

To measure correctly, you need the pregnant woman to take a prone position. She is asked to lie on the couch on her back, her legs are asked to be slightly bent at the knees. It is important that before the measurement, the woman visits the toilet and be sure to empty the bladder from its natural contents.

Next, the obstetrician-gynecologist needs to establish in what position the baby is located, where the bottom of the uterus is, and also what part of the body the baby is adjacent to it. The doctor places both palms on the stomach, and directs the fingertips towards each other (Leopold's first obstetric reception). This sets the most distant point of the bottom of the reproductive organ relative to the line of the pubic bone. Then they apply a centimeter tape to this point and simply determine the numerical value, which expresses the height of the uterine fundus.

If the doctor is a big fan of the old obstetric school, then he can use the finger method. He presses his fingers to each other (middle and index), they should be located transversely on the stomach. Height is determined in fingers, and then converted to centimeters (2 transverse fingers = 3–4 centimeters)

Why do you need to define this parameter?

Each obstetrician considers it his duty to measure VDM, not only because the instructions provide for this, but also because this method is one of the most accessible in order to understand whether the course of pregnancy is normal. VSDM, despite the fact that the size is associated with errors, is one of the indicators of the gravidogram (general table of indicators of a pregnant woman). This is a special table that displays the entire course of the gestation period in the form of graphs: there is a weight gain graph, a pressure graph, a graph of the abdominal circumference and a graph of the VSD.

During almost all weeks of gestation, the height of the fundus of the uterus is in accordance with the term in numerical terms, and only before childbirth, when the abdomen drops, the fetus shifts lower and begins to press the head of the internal cervical os of the cervix, helping it to mature and prepare for disclosure in childbirth, VSD decreases. The belly visually also becomes lower, and it becomes somewhat easier for the expectant mother to breathe and move.

According to the VSDM, the doctor can also guess without an ultrasound machine how much the fetus supposedly weighs, whether it is full-term. After childbirth, or rather, after the birth of the placenta, this size helps specialists to establish how well the uterus contracts.

Timing Compliance and Table

If the circumference of a pregnant woman’s abdomen is a rather individual and subjective value (women’s bellies have different sizes even before the onset of an “interesting position”), then VSDM does not depend much on how thin or fluffy the lady is, tall or short. This value is more constant, and therefore we can talk about the average norms of the height of the bottom point of the reproductive organ for different periods of pregnancy.

Anatomical landmarks help in clarifying the timing:

• by 16 weeks pregnancy, the upper part of the uterus is located in the middle of the path from the womb to the navel;
• by week 20 pregnancy, the high point of the bottom is located approximately 2 transverse fingers below the navel;
• by 24–25 weeks- the bottom line is compared with the navel location line;
• by 28–29 weeks- 2 transverse fingers above the navel;
• by 31–32 weeks- the bottom of the uterus is located exactly in the middle between the navel and the xiphoid sternal process;
• by 36 weeks- the bottom of the uterus, if it has not yet descended, is located almost at the xiphoid process at the level of the ribs;
• by 40 weeks- the descended uterus is again in the middle between the navel and the xiphoid process.

The minimum height is considered at the end of the first and beginning of the second trimester, and the maximum bottom of the uterus reaches 35–36 weeks.

If the values ​​are not correct

The dome-shaped part of the female reproductive organ grows simultaneously with the baby, increasing in weeks of pregnancy, in fact, that is why WMD is measured so diligently. Until the 27th week of pregnancy, the height increases by about a centimeter or two per week, after 28 weeks, the rate decreases slightly, and the bottom rises by about 1.5 cm per week, and after 36 weeks, the growth rate decreases to a minimum - 0.2–0, 5 cm per week. If for several measurements of the growth of VDM is not observed, or, conversely, the growth is too fast, they speak of a mismatch with the timing.

A lag of 2 centimeters or more from the standard values ​​\u200b\u200bmay be due to one of the following reasons:

• erroneously established terms of pregnancy, late ovulation;
• a healthy baby, but with a low body weight (genetic inherited constitution);
• IUGR - intrauterine growth retardation;
• a small amount of water;
• transverse or oblique position of the fetus in the uterine cavity;
• wide pelvis of the expectant mother.

Exceeding the VSDM by 2 centimeters or more from the standard values ​​\u200b\u200bmay indicate:

• erroneously determined gestational age;
• incorrect measurement (for example, with a full bladder);
• narrowness of the pelvis of a woman;
• multiple pregnancy;
• healthy baby, but with a large body weight (hereditary factor);
• the presence of diabetes in a woman, including its gestational variety;
• polyhydramnios;
• pelvic presentation of the fetus, in which the legs or buttocks of the crumbs are directed forward.

You should not immediately begin to worry and be nervous - this is generally superfluous in such a situation. In addition, according to medical statistics, the most common cause of deviations from the real indicators of the VVDM is a banal error in determining the gestational age or an incorrect calculation. This is possible with an irregular female cycle, when a woman does not remember the date of the last menstruation, after IVF.

In second place in popularity is such a reason as the weight of the fetus. You need to understand that not always the baby should weigh exactly as much as indicated in the tables with norms. There is a genetic predisposition, and after 10 weeks of pregnancy, all children grow according to their own genetic program, which was laid down by their parents.

One is destined to be large, and the other is destined to be miniature. At the same time, both of them will be perfectly healthy children. Look closely at yourself, at your partner, at your parents and yours. Assess height, weight, physique. Perhaps this is your case.

If developmental delay is suspected, ultrasound with Doppler is prescribed, from 30-31-32 weeks - CTG, this allows you to find out how well the baby's heart beats, whether he receives enough nutrition from the bloodstream. Screening for intrauterine infections. With IUGR, there are a lot of methods of providing assistance, and in most cases, doctors manage to quickly, by eliminating the cause that negatively affects the child, normalize its growth rate.

The width of the pelvis plays an important role. In women with a narrow pelvis, the stomach becomes noticeable much faster, because the uterus leaves the cramped pelvis faster and rises higher than the average values. A wide pelvis is more capacious, and slight deviations of the VDM to a smaller side are possible.

An examination on the occasion of deviations of the WDM from the norms is prescribed in any case, because it is better, as they say, to play it safe. It includes blood donation by a woman for sugar and infections, ultrasound and dopplerography.

But even if the reasons are not found and the genetic characteristics of the child are assumed, then the woman will be observed more closely, it may be necessary to visit the doctor more often, as well as take tests.

How to calculate the weight of a child according to WDM?

To determine the estimated weight of the baby, today they are increasingly resorting to ultrasound diagnostics, since its results are much more accurate. But obstetric formulas, which have already become history, can be applied by women on their own, at least to satisfy their own curiosity. There are several ways.

By Lankowitz

You need to take the last two sizes indicated on the date of the last visit to the antenatal clinic: the circumference of the abdomen of a woman and VDM. You also need to know your height and weight.

The algorithm is the following:(VSDM + coolant + height + weight) x10.

Example: gestational age 30 weeks, OB = 115, VSD = 30, height - 170 cm, weight - 75 kg. (115+30+170+75) X10= 3900. The error of the formula is about half a kilogram, both positive and negative.

By Bublichenko

For such a calculation, you need to know the exact weight of the expectant mother. It is divided by 200 and multiplied by 10. For example, in a pregnant woman who weighs 80 kilograms, the baby will weigh about 4 kilograms. The error is about a kilogram in both directions.

By Yakubova

This method is more accurate than the previous two, but in many ways loses in the accuracy of ultrasound. Formula: ((WDM + coolant) / 4) x100.

If a woman's WMD is 30, and the abdominal circumference is 115, then the estimated weight of the baby in the womb at the current time is 3625 grams. It is important to understand that the formula is applicable only to women with no excess adipose tissue in the abdomen.

By Jordania

The formula is simple: OzhkhVDM, which usually means multiplying one indicator from an exchange card by another. With a WDM of 30 cm and a coolant of 100 cm, the estimated weight of the baby in the womb is 3300 grams.

Important! Of all the formulas, the Jordanian method is considered the most accurate.

Self measurements

Self-measurement of the height of the rise of the domed part of the uterus above the womb is much easier than deciphering the measurements. At home, a woman may well do this without outside help. Knowing how doctors do it (described above), you can similarly use a centimeter tape, and if it is not at hand, then by the method of two folded fingers. It is important to go to the toilet, empty your bladder and take a comfortable horizontal position with your legs slightly bent at the knees.

A bed with a soft mattress is not suitable for measurements - the surface on which the expectant mother will be located must be hard. The self-determination algorithm is quite simple:

• determine the location of the pubic bone, its upper border;
• gently feel the bottom of the reproductive organ, smoothly rising from the edge of the pubic bone to the navel and above (to the touch, the bottom looks like a comb with uneven contours);
• using any of the above methods, measure the distance from the edge of the pubis to the high bottom point.

Do not make mistakes, try to apply the zero mark of the centimeter tape to the edge of the pubic bone. Remember that VDM is measured not in mm, but in cm.

Be sure to take into account the peculiarities of your pregnancy, in particular the position of the fetus (the doctor reports about it at the appointment), the number of children, with twins, the weight of the fetus will be less, and the size of the uterus due to the stretching of the walls will be larger.

Evaluation of the height of the uterine fundus by weeks of pregnancy has a serious diagnostic value. In addition to calculating the gestational age, gynecologists predict the condition of the fetus every week, and suggest possible deviations from its normal development.

The length of the uterus is not more than 8 centimeters in a woman of reproductive age. Of these, the neck takes about 2.5 cm. Height - 4 cm. The uterus increases during pregnancy and by the 40th week of the term has a similar length - 40 cm. Before pregnancy, the weight of the organ is 50 grams. In the third trimester - about 4 kilograms.

The height of the fundus of the uterus by week - how to determine

• In the early stages, we probe the size of the uterus through the vagina.
• 12th week - the uterus reaches the pubic symphysis.
• From the 13th week, it goes beyond the pelvic region, and is palpable through the abdominal wall.
• In the supine position, a pregnant centimeter tape measures the distance between the pubic symphysis and the highest point of the uterus (bottom).
• The results are recorded in a notebook to track their dynamics.
• Approximate dimensions of the height of the bottom of the uterus by weeks in centimeters: 8-9 weeks - 8-9; 16-17 weeks - 14-19; 38-39 weeks - 35-38.
• The bottom standing height (VVD) roughly corresponds to the gestational age in weeks.

If at a certain time the height of the uterine fundus exceeds normal values, then the doctor may suspect a multiple pregnancy, and if less, low fetal growth rates, oligohydramnios, oblique or transverse position.

A one-time determination of the height of the uterine fundus is uninformative.

It should be noted that the size of the IRR at various stages of pregnancy is average. It differs in large and short women, who have anatomically different sizes of uterus.

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

IN 8-9 weeks the uterus is the size of a goose egg. Until this time, it is not palpable through the abdominal wall, as it is located in the pelvic area. Only from 3 months - located above the pubis. The placental system begins to function actively, and the corpus luteum gradually disappears. The embryo begins to move, blood vessels form in it.

10-13 weeks. The length of the uterus is 11 cm. Toxicosis increases due to the cleansing of the mother's body, which is being rebuilt to normalize the trophism of the fetus.

14-16 weeks. The embryo completes the process of creating organs. The uterus increases to 14 cm.

16 weeks- the bottom of the uterus is located in the middle of the distance between the navel and the pubis.

17-18 weeks. Formed placental system. The fetus has a fully developed cerebellum, limbs, immune system. The length of the uterus is 18-19 cm.

WITH 20th week the size of the standing of the bottom of the uterus begins to approximately correspond to the duration of pregnancy. So on the 21st week, the value of the distance between the pubis and the bottom of the uterus is approximately equal to 21 cm. In the future, it increases by 1 cm every week. The bottom of the uterus is projected at this time below the navel by 2 fingers.

22-24 weeks. The embryo develops muscles and bones. Its weight is about 600 grams. At the 24th week, the pulmonary system begins to form. The uterus increases to 23 cm. At the 24th week, the bottom of the uterus is located in the navel with a height of 24 centimeters.

28 weeks the height of the bottom of the uterus is 28 cm. The bottom of the uterus is placed 2 cm above the navel (two folded fingers).

29-30 weeks. In the third trimester, the uterus is about 31 cm. In a pregnant woman, blood pressure rises due to the large size of the fetus.

32 weeks- the location of the uterus in the middle of the distance between the xiphoid process of the sternum and the navel (9th month), and is 32 centimeters.

36 weeks- on the line that connects both costal arches.

38 weeks. After the 38th week, the uterus begins to descend. The bottom of the organ presses on the stomach and diaphragm. The mother slowly digests food, heartburn appears. The weight of the child is 2100-2250 grams.

On 40th week VDM - 32 cm. The bottom is again located between the ribs and the navel. Pregnancy is considered full-term. The child is actively growing, and the mother's body is preparing for childbirth. When the baby descends into the pelvis, childbirth will come.

The height of the fundus of the uterus by week, which affects it:

• fruit size,
• Anatomical features of the woman's body,
• The position of the fetus
• Number of embryos
• Expression of amniotic fluid.

If the bottom of the uterus during pregnancy is below normal

• oligohydramnios,
• Wide pelvis in large women
• Erroneous values ​​in determining the timing of pregnancy,
• Delayed fetal development.

Assessment of the size of the location of the bottom of the uterus during pregnancy should include a whole series of measurements.

If the bottom of the uterus during pregnancy is above normal

• narrow pelvis,
• big fruit,
• polyhydramnios,
• multiple pregnancy,
• Wrong position.

Simultaneously with the height of the fundus of the uterus, gynecologists calculate the amount of amniotic fluid, which affects the development of the fetus. This indicator depends on the individual characteristics of the development of the woman and the total thickness of the subcutaneous heat. At the end of the gestation period, both indicators allow you to calculate the weight of the fetus according to the formula: VVD - abdominal volume. The normal value is approximately 3420 grams.

Content

From the moment of conception to birth, the size of the fetus gradually increases. The growth of the uterus observed in this case by weeks of pregnancy is a normal physiological process. According to the dynamics of this indicator, an experienced gynecologist monitors the features of changes in the state of the mother and the development of the embryo, can notice the complications or pathologies that have arisen in time and take measures to eliminate them. Measurements are made and recorded by the doctor at regular scheduled examinations; from the second trimester, a woman can perform them on her own, at home.

What is the size of the uterus by week of pregnancy

The size of the uterus in nulliparous women averages from 4.5 to 7 cm in length and from 4.5 to 6.5 cm in width, thickness - 3.5-4 cm. Individual parameters may deviate from the physiological norm by 2-3 see After the onset of pregnancy and implantation of the embryo, an increase in the organ begins (under the influence of the growth of the fetus), which continues until the last prenatal weeks. By childbirth, the size of the uterus reaches 33-40 cm.

By changing the location of the uterus and the parameters of its growth, an experienced specialist can determine the gestational age, the nuances of its course, and the developmental features of the fetus. To track the dynamics of organ enlargement, at each scheduled examination, the gynecologist measures the volume of the abdomen, the width of the pelvis. With the beginning of the second trimester, an indicator of the height of the fundus of the uterus (VSD or VDM) is introduced.

The height of the bottom of the uterus by weeks of pregnancy is the distance between the pubic symphysis and the highest point of the organ, measured with a regular centimeter tape. On average, this indicator corresponds to the period - from 8-9 cm in the eighth to ninth week, to 35-40 cm - in the fortieth. Deviations may indicate a multiple pregnancy (with increased values) or pathologies (wrong position of the fetus, developmental delay, oligohydramnios). The method of such diagnostics is indicative only in dynamics, one-time measurements are not informative.

Features of changes in the uterus during pregnancy

The process of organ enlargement occurs gradually, measuredly, therefore, normally it does not cause discomfort to a woman. Drawing pains, other unpleasant symptoms occur against the background of sprains or the formation of adhesions during polyhydramnios, multiple pregnancies, or due to scars after previous surgical operations. The size of the uterus depends on the trimester and varies as follows:

1. First trimester. The uterus is located behind the pelvic bone, the shape resembles a pear. At the sixth week, the size of the organ reaches the volume of a chicken egg, at the eighth - a goose. By the end of the trimester, the uterus takes on a round shape, increases three times from the initial size.
2. Second trimester. The organ is centered in the pelvic region, acquires symmetry, begins to be felt through the abdominal wall, as it comes out from behind the pubic bone.
3. Third trimester. The organ again takes the form of an egg, stretching to the bottom. The uterine cavity increases 500 times compared to the beginning of pregnancy, the weight of the organ changes on average from 50 g to a kilogram (muscle fibers lengthen, thicken, the vascular network develops).

The height of the uterine fundus by weeks in each trimester increases in parallel with the development of the fetus. It goes through the following main stages:

• 8-9 weeks of obstetric period - the average volume of the organ corresponds to a goose egg, it is not palpable through the abdominal wall.
• 10-13 - the organ rises above the pubic bone; the activity of the functions of the placental system increases, the corpus luteum gradually disappears. The fetus develops the vascular system, it begins to make the first movements. VDM - about 11 cm.
• 14-16 - completion of the formation of the internal organs of the embryo. The uterus reaches a size of 14-15 cm. At 16 weeks, the position of the bottom height reaches the middle between the navel and the top of the pubic bone.
• 17-19 - the fetus develops the immune system, limbs, cerebellum. The organ increases in size up to 19-20 cm.
• 20 weeks and beyond - the gap between the bottom of the uterus and the pubis reaches 21 cm, then this figure increases by an average of 1 cm per week. The SMD is located about two fingers below the navel.
• 23-24 - the weight of the fetus reaches 0.6 kg or more, it develops muscles and bones, and the respiratory system is formed. VDM - 24 cm.
• 28 - VDM about 28 cm, located 2-3 cm above the navel.
• 29-30 - the size of the organ reaches 31-32 cm.
• 32 - the uterus is located in the center between the navel and the xiphoid process of the sternum, VDM - about 34 cm.
• 38 - the gradual omission of the organ begins, accompanied by strong pressure on the diaphragm and stomach.
• 40 - the size of the uterus ranges from 32-34 to 40 cm, depending on the physiological characteristics of the mother's body, the size of the fetus, and a number of other factors.

Uterus Size Chart by Week

Indicators of the standing height of the bottom and the size of the uterus are physiological, therefore, deviations from the fixed norms within 2-3 cm in most cases arise due to the characteristics of the mother's body and individual nuances of the course of pregnancy. The dynamics of changes in the size and position of the body in accordance with different periods is presented in the table:

Until about 16 weeks, it is difficult to determine the location of the fundus of the uterus, because the organ is covered by the pubic bone. From the 20th week, the bottom is well palpable through the abdominal wall in the presence of a small layer of fat. From the 24th week, the height of the fundus is located in the navel, further, until the prenatal weeks, including them, the depth of the bottom of the uterus and the organ itself are perfectly palpable through the abdominal wall. In parallel with the growth of the size of the organ itself, there is a slight decrease in the length of its neck.

Deviations from the norm

The location of the uterus by weeks of pregnancy and its size during normal growth and development of the fetus change at approximately the same pace in all women. If the doctor fixes in the dynamics deviations from the average normal indicators (taking into account the physiological individual characteristics of the mother) up or down, he prescribes a number of additional examinations in order to timely prevent the development of dangerous complications.

Indicators below the norm

When changes in the size of the uterus by weeks of pregnancy deviate from the norm downwards, doctors, depending on the timing, prescribe a number of additional diagnostic examinations (for example, ultrasound). Such indicators may indicate an inaccurate determination of the term, a thin physique of the mother. Ultrasound also helps to identify possible pathologies that threaten intrauterine malformations and abnormalities in the development of the fetus:

• Up to 13-14 weeks, the reduced size of the organ may be evidence of an ectopic pregnancy.
• In the second trimester, low rates of organ enlargement may indicate fetal growth retardation (hypotrophy), oligohydramnios, placental insufficiency (against the background of maternal infectious diseases), preeclampsia.
• In the later stages, a reduced UDM accompanies the transverse presentation of the fetus, sometimes this is observed with a wide mother's pelvis.

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 a 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).

As soon as a woman found out about her interesting situation, you should immediately contact a antenatal clinic. The doctor will assess the woman's health, if necessary, make an ultrasound of the pelvic organs, examine the patient on the gynecological chair, take swabs and give directions for other tests. All these manipulations are necessary in order to realistically assess the state of health of the pregnant woman and set the exact date. The gynecologist at each visit pays close attention to the condition of the uterine fundus during pregnancy.

Why is it necessary to constantly monitor the height of the uterine fundus? Not every woman in a position knows how important these indications are for a gynecologist leading a pregnancy. Since the fetus develops in the uterus, then a serious attitude to this organ is fully justified. So, in order to determine the exact gestational age in the early stages, a standard gynecological examination is enough for a gynecologist, but after the 13th week it is no longer possible to assess the condition of the uterine fundus. Therefore, in order to assess the compliance of the VMF (height of the fundus of the uterus), the specialist resorts to a different method and measures the circumference of the abdomen.

Why are these indications necessary? First of all, to make sure that an accurate diagnosis was made earlier, namely, what week of pregnancy you are now, whether the size of the uterus corresponds to the established norms, and when the birth will begin. That is why every woman in position, starting from the 2nd trimester, should not be too surprised when the gynecologist, at each visit to the antenatal clinic, measures your rapidly rounding tummy with a centimeter tape.

What is WMD during pregnancy

In medicine, there is such a term as VDM - this is the height of the fundus of the uterus during pregnancy. To get a figure, you need to measure the distance between the pubic joint and the wall of the uterus in the upper part (protruding part).

So, the uterus begins to rapidly increase in size after 4 obstetric months, or from 16 weeks, so it is best to determine this indicator by probing and measuring the anterior abdominal wall. Until the 16th week, the gynecologist could determine this indicator only on the gynecological chair by vaginal examination.

In the normal state, the length of the uterus is approximately 8 cm. About 2-2.5 cm should be subtracted from this figure - this is the size of the cervix. It turns out that the height of the reproductive organ in the normal state (before conception) or its length is 4 cm. The uterus can only increase with the onset of conception and by the end of pregnancy. By the 36th week, its size should be 36 cm.

The weight of the uterus before pregnancy is on average about 50 g (depending on the woman's build), and before the birth itself - about 4 kg, again, this is the average figure, if the woman is obese or vice versa, graceful, then the size and weight may differ from this figure.

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

Only a specialist should be engaged in measuring VDM, there is no need to do this on your own, and also for fun, ask a friend or mother. All the same, only a qualified specialist will be able to obtain accurate indicators in order to then compare the results obtained with the data of the VDM table.

Correctness of measurements:

1. Before entering the gynecologist's office, it is necessary to visit the toilet so that the bladder is empty.
2. In the office, the pregnant woman should lie on the couch (on her back), straighten her legs and relax.
3. The specialist, armed with a soft centimeter, measures the tummy: the distance from the pubic bone to the upper part of the wall of the reproductive organ.
4. The resulting figure is compared with the table to determine the development of the fetus, position, amount of amniotic fluid.
5. The whole manipulation takes a little less than a minute, it does not hurt.

WDM table during pregnancy:

The table shows generally accepted numbers that correspond to a certain gestational age. It should be borne in mind that these are average indicators and the size of the uterus in each case may differ from the numbers indicated in the table by 3 units. Therefore, you should not find fault with these indicators and ask the doctor, he controls the situation himself.

By the way, a few weeks before the upcoming birth, the baby's head goes down into the small pelvis, so the VDM does not correspond to the deadline (the number of weeks is an indicator in centimeters). That is, at 40 weeks, you should expect WDM not 40 cm, but less.

WDM by week of pregnancy

There are generally accepted standards that are followed by all gynecologists without exception, but sometimes VDM does not meet the standards.

What are the reasons:

• if the fetus is large or vice versa, too small, then the size of the uterus will differ from generally accepted norms;
• narrow or wide pelvis;
• the position of the fetus - if the baby is not properly located in the womb, then the size of the uterus will be different;
• multiple pregnancy. Naturally, if there are not 1, but several embryos in the uterus, then its size increases;
• much or little water.

The norm of VDM during pregnancy by week:

• Let's start with 2 months. The uterus is not yet palpable through the abdominal wall, since it is located in the small pelvis. Only from the 3rd obstetric month will it go beyond the pubis;
• at 10-13 - 10-11 cm;
• at 14-16 - 13-14 cm;
• 16 weeks - 15 cm;
• at 18 weeks - 17-18 cm;
• from the 20th week of WDM - 21 cm. From this period, the uterus should increase by 1 cm per week (average readings);
• from the 22nd to the 24th week, the size of the VDM is 23 cm, the height from the pubic bone to the top of the uterus is 23-24 cm;
• 28th week - the uterus grows a few more centimeters and is located just above the level of the navel (during palpation, the doctor puts 2 fingers to the stomach to feel the top of the uterus);
• 30th week, the uterus reaches a size of 30-31 cm;
• at 36 weeks, WDM is equal to the target date;
• at the 38th week, the uterus slowly descends, dimensions - 35-36 cm;
• at the 40th week, the uterus shifts lower, accordingly changes in size. VDM is only 32 cm.

Let's talk about the shape of the tummy

Experts pay attention not only to the size, but also to the shape of the abdomen. Even in the old days, grandmothers and healers could determine the gender of the child by the shape of the tummy. But now it's not about that. We need to find out how related these two indicators are.

For example, if we take into account the size of the fetus, the rate of its development, and the position it occupies (correct or not), the size of the UDM will also depend. But that's not all, it is necessary to take into account other indicators: the physique of the expectant mother, her weight, the shape of the pelvis, as well as the thickness of the subcutaneous layer in the abdomen (fat deposits). Plus, it is also necessary to take into account the number of embryos, which is very important, and how developed the abdominal muscles are. So, if the abdominal wall is stretched, then the size of the abdomen changes.

There are no generally accepted standards for the shape and size of pregnant tummies, everything is purely individual. But still, gynecologists pay attention to many things. Even if a woman in her first pregnancy looked different than in her second, conclusions can already be drawn. This applies to the size of the abdomen.

What are the standards? The abdomen during the bearing of the crumbs should be of the correct shape, slightly pointed (ovoid) and directed slightly upwards. This applies to women who are carrying their firstborn. The situation is different with multiparous ones, the shape of the tummy and size are already changing. For example, a tummy like a huge inflated ball or even a square one is worn by owners of weak abdominal muscles or if the baby is very large, and the woman also has polyhydramnios.

Let's consider one more example: a woman is graceful, but bears a hero, then her tummy also differs from the generally accepted norms in size. Or if the stomach looks like a soft ball, then polyhydramnios is possible.

A pear-shaped belly, slightly sagging to the ground, is typical for women who have weak abdominal muscles (they are not able to hold such heaviness).

A narrow pelvis or multiple pregnancy - the shape of the abdomen is more pointed, the tummy itself is larger than usual. But an inconspicuous belly, very small and neat, may indicate oligohydramnios (an exception, graceful women and the same fetus).

An asymmetrical belly can be a cause for concern because it indicates the wrong position of the fetus in the womb. If the child lies across, then the stomach takes on an elongated shape and looks like a horizontal oval. As you can see, there are a lot of signs that affect the size of the WDM.

If WMD is less than the gestational age

If, after measuring the height of the uterine fundus, a figure was obtained lower than indicated in the table, this may mean that the woman was incorrectly set the gestational age, as well as with fetal growth retardation and oligohydramnios. By the way, a wide pelvis can also be the cause of a lag in the growth of the uterus, since it remains in the lower pelvis longer than the due date, and the fetus develops normally, without deviations.

In addition to the fact that by measuring the tummy of a woman in position, you can find out the height of the fundus of the uterus, this indicator directly indicates the weight of the fetus. You can get an approximate figure and find out the weight of the baby if you multiply the VDM in centimeters by the circumference of the abdomen (also in cm). The error of such an indicator, according to the opinion of experienced obstetricians, is 100-150 g.

We draw conclusions: if the indicator of the height of the fundus of the uterus differs from the generally accepted norm, then you should not immediately panic and get very upset. Perhaps you have incorrectly set the gestational age, based on this, the WDM figure will also be different. In addition, immediately set yourself up for positive and do not find fault with the testimony too much, this does not mean that the child is lagging behind in development. To dispel all doubts, you need to pass tests, go for an ultrasound.

By the way, if the WDM indicators are underestimated, then the doctor may recommend to go to the hospital under observation and undergo an extended examination - this is CTG and Doppler. If deviations are found, do not worry, and most importantly, do not ignore the prescribed treatment, you will see, everything will be fine!

When WMD is longer than the gestational age

If, after measuring the uterus of a pregnant woman, the doctor suspected that the VMD is much different from the standard indicators, then this may indicate that the woman has:

• the fetus is too large, and the pelvis is narrow (even when the fetus is of normal size, the narrow pelvis overestimates the WMD);
• a pregnant woman has polyhydramnios;
• the baby has taken the wrong position;
• if the pregnancy is multiple.

By the way, if a woman is carrying twins or even triplets, then already at a period of 16 weeks, the WDM indicators are noticeably different from the norm (exceed by 3 cm).

If your indicators are overestimated, you should not immediately panic, but you also do not need to rejoice, since the WDM above the norm may indicate that the woman has an infection and the amount of amniotic fluid is above normal. What do we have to do? Follow the recommendations of the gynecologist observing your pregnancy, undergo an additional examination (pass tests, undergo ultrasound, CTG and dopplerometry). After a full examination, conclusions can be drawn.

How to measure WMD yourself

If curiosity does not leave you and you want to personally verify the correctness of the measurements by the gynecologist, then you are too concerned about your interesting position, you are allowed to measure the VDM yourself. This can be done at home, armed with a centimeter.

How to measure WMD at home:

1. You need to first go to the toilet a little at a time to empty your bladder.
2. Then you need to lie down on a bed or sofa so that your legs are straightened, relax.
3. Now stroke your round tummy and feel the uterus with your fingers. You should feel that there are hard places, and there is a border where the uterus goes from a solid state to a soft one. This is the bottom of the uterus.
4. Now you need to take the tape in your hands and measure the distance from the pubic bone to the point found.
5. That's all, the resulting figure is the size of the VDM. Let's say that you are now 28 weeks pregnant, you measured your tummy and got a figure of 26 cm. Everything is in order, the pregnancy is without deviations and corresponds to the term.

Remember that by the end of the pregnancy, a few weeks before the birth, the uterus will begin to sink lower, and the UMR will no longer correspond to the gestational age. You can be congratulated, because very soon you will become a mother!