Measurement of fundal height.

Fundal height should not be assessed by comparing the uterus with anatomic landmarks on the maternal abdomen because of the following reasons: 1) the inability to assess fundal growth accurately when the uterus is measured in finger breadths or as a fraction of the distance between two landmarks; 2) biologic variability in the placement of anatomic landmarks on the maternal abdomen; 3) disagreement among clinicians and researchers on the precise relationship between the fundus and anatomic landmarks at each stage of gestation; and 4) variability among women in the number of gestational weeks at which the uterine fundus reaches the umbilicus. A rational basis for continuing the practice of comparing fundal height with anatomic landmarks on the maternal abdomen does not exist. Inexpensive and more accurate techniques of measuring fundal growth are readily available.