Maternity Nursing Q 63

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In Bartholomew’s Rule of 4, when the level of the fundus is midway between the umbilicus and xiphoid process the estimated age of gestation (AOG) is:

  

     A. 5th month

     B. 6th month

     C. 7th month

     D. 8th month

    

    

Correct Answer: C. 7th month

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In Bartholomew’s Rule of 4, the landmarks used are the symphysis pubis, umbilicus, and xiphoid process. At the level of the umbilicus, the AOG is approximately 5 months and at the level of the xiphoid process 9 months. Thus, midway between these two landmarks would be considered as 7 months AOG.

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Option A: The uterus has been described as a soft and globular pelvic organ. In pregnancy, the uterus increases in size to accommodate the developing fetus. At approximately 12 weeks gestation the uterus becomes large enough to be palpable just above the pubic symphysis.

Option B: At 16 weeks gestation, the fundus of the uterus can be palpated at the midpoint between the umbilicus and the pubic symphysis.

Option D: At 20 weeks gestation, the fundus can be palpable at the level of the umbilicus. After 20 weeks of gestation, the pubic symphysis to fundal height in centimeters should correlate with the week of gestation.

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