Welcome back to parently Mark Boyd here and today we're going to talk about the importance of fundal height measurements, and fetal heart rate assessment. It's important to understand why we do these. Now the most important thing to understand as a patient is that your dating has to be correct. Prior to ultrasound or sonograms, we use the fundal height measurements to establish whether the baby is growing appropriately. So in today's world, even though we still do fundal height assessments, it's not nearly as important as it was even 25 years ago. So what is fundal height mean?

And what how do we measure that it's a measurement from your pubic bone to the top of the uterus. This is called your fundal height. If you can look at your belly button and measure from your belly button to your pubic bone. That's about 20 centimeters for most women. That's the mid portion of your pregnancy. So fundal height of 20 at 20 weeks, this typically is kind of the starting point of when we measure fundal height, each four weeks that we see you up until 28 weeks and then every two weeks after 28 weeks, we measure fundal height.

And usually the number of weeks that you are is consistent with the fundal height measurements. So if you're 30 weeks, in general, your fundal height should be about 30 centimeters. Now, in today's world, with obesity becoming such a significant problem in many, many of our patients fundal height is not nearly as accurate as it was even 25 years ago before the obesity epidemic. So there are some healthcare providers that do not even measure the fundal height anymore. They simply rely on measurements on ultrasound to determine whether the baby is growing appropriately or getting too big. So if your healthcare provider does not measure your fundal height that does that, no mean, they're doing a bad job.

That just means they're assessing the baby in a different modality. But it has to be assessed in some mode either fundal height from my ultrasound. The second topic today is fetal heart rate monitoring. Now, dating again is the most important, we cannot identify fetal heart tones until you're about 12 or 13 weeks. However, if you're a patient that is very, very obese, a BMI of greater than 35, we may not be able to hear the baby's heart rate, even at 12 weeks, it may be 15 or 16 or 17 weeks when we can hear the baby's heart rate. So if that's the scenario for you don't get worried.

Probably your health care provider is going to establish heart tones based on ultrasound, and that may be needed every single visit if they can't hear the baby's heartbeat. With a normal fetal heart rate Doppler it's important to understand that the normal heart rate for the baby is 120 to 106 This range is not an isolated event. In other words, there are patients that are babies that have heart rates greater than 160. for short periods of time. There are babies that have heart rates of less than 120 for short periods of time. This is a normal variant. However, if this happens, your healthcare provider may put you on the monitor what's called a non stress test where they hook you up to belt and monitor the baby's heart rate.

Or they may take you to the sonogram room and look at the baby's heart and establish the rate through ultrasound guidance. These are normal standard protocols. If the heart rate is greater than 160. Less than 120. Patients often asked me Should they buy a Doppler for home monitoring? I think this has positives and I think this has negatives.

The positives obviously establishing is My Baby Alive every day is a great positive. Some patients are so anxious that If they don't feel the baby move in a certain manner every single day, they become very concerned. So in those patients, I think having a fetal heart rate Doppler and establishing the heart rate is a good idea. Now, this can also be a problem for two reasons. Number one, sometimes establishing the fetal heart rate is difficult where to put the monitor. And if you don't put it in the correct place, you don't feel that you don't hear the baby's heart rate that can cause anxiety.

And obviously, you're gonna have to come into the office. The other issue is what do you do as a patient? If the baby's heart rate is greater than 160, less than 120. You don't know what to do. So in that situation, you're going to become anxious and you're going to need to be evaluated. So although I don't discourage patients from getting a monitor, I think it's important understand what to be concerned about in those two scenarios.

Have a great day.