It helps assess if the baby is growing properly and helps determine the gestational age of the baby. How do you measure fundal height? To measure the fundal height you must remember two important anatomical structures: symphysis pubis and the fundus of the uterus. The symphysis pubis is a joint of cartilage that sits in between the pubic bones see image below. The fundus is the top part of the uterus see image below. To measure the fundal height, which is measured in centimeters , you will take a tape measure and extend it from the symphysis pubis to the fundus of the uterus.
Lay the patient down on their back. NOTE : monitor the mother for supine hypotension because she is at risk for this, especially if she is late into her pregnancy. Avoid sexual activity, douching or tampons until your postpartum visit. From 12 to 20 weeks By about 16 weeks of pregnancy the top of the uterus or fundus will have grown to about halfway between the pubic hair line and the belly button or navel felt when lying down.
By about 20 weeks of pregnancy the fundus should be close to the level of the belly button. This position can be deceptively reassuring. ROP is the most common of the four posterior positions. Right Occiput Posterior — Baby's back favors mother's right and the back of baby's head is towards mother's posterior. All postpartum women should have regular assessment of vaginal bleeding, uterine contraction, fundal height, temperature and heart rate pulse routinely during the first 24 hours starting from the first hour after birth.
Blood pressure should be measured shortly after birth. Fundal height, or McDonald's rule, is a measure of the size of the uterus used to assess fetal growth and development during pregnancy. It is measured from the top of the mother's uterus to the top of the mother's pubic symphysis. Most caregivers will record their patient's fundal height on every prenatal visit.
So in the U. How is Fundal height measured after delivery? Category: family and relationships pregnancy. The fundal height is above the symphysis pubis at 12 weeks. It is at the belly button navel or umbilicus at 20 weeks.
After pregnancy 1 hour after delivery , the fundus is at the umbilicus. It will decrease 1 cm per day and be non-palpable by days. Where should the fundus be 8 hours after delivery?
Why do they massage the uterus after birth? Should you massage a firm fundus? How is a Fundal assessment conducted? How often do you massage the fundus after delivery? How do you measure your pregnant belly with a tape measure? What does a boggy uterus mean? What side of the stomach does a baby grow? C-section patients may have vertical or horizontal incisions that will need to be assessed throughout the postpartum period.
The REEDA method redness, edema, ecchymosis, discharge, and approximation can be used to assess these incisions. It is important to teach patients to examine their incision each day with a mirror or have a family member monitor the incision for them.
Patients are instructed to immediately report any abnormal findings, such as hematomas, abnormal drainage, odors, or significant pain, to their healthcare provider. Postpartum hemorrhage is one of the leading causes of death among postpartum women. PPH refers to a blood loss of at least mL after a vaginal birth and at least mL after a C-section. Postpartum hemorrhage is categorized as early or late.
Early refers to a hemorrhage occurring within the first 24 hours after birth, while late refers to a hemorrhage occurring 24 hours to 12 weeks after delivery. Early postpartum hemorrhage is often caused by uterine atony, or a failure of the uterine muscles to contract properly, thereby inhibiting the healing of blood vessels at the site of placental attachment.
The blood vessels continue to bleed until the uterine muscles contract. Signs of uterine atony include a boggy uterus, a fundus that is higher than expected upon palpation, and excessive lochia. The nurse must report a PPH immediately and prepare for the insertion of a large-bore intravenous catheter, if one is not already present, and the administration of intravenous fluids and oxygen. In the case of an early PPH caused by damage to the birth canal, surgical repair is usually necessary.
A sequelae of PPH is hypovolemic shock. In the presence of a PPH, hypovolemic shock can occur and cause severe organ damage and even death if untreated. These patients will also require oxygen usually 8—10 L via face mask , IV fluids, and possibly blood products. This is a very serious situation, and nurses must be prepared to assist in this life-threatening emergency.
Women can suffer from thrombophlebitis as a result of venous stasis and the normal hypercoagulability state of the postpartum period. Thrombophlebitis is an inflammation of the blood vessel wall in which a blood clot forms and causes problems in the superficial or deep veins of the lower extremities or pelvis.
All postpartum women are at risk. However, certain risk factors predispose some women to developing thrombophlebitis. These risk factors include:. The blood clot that develops in thrombophlebitis can lead to a life-threatening pulmonary embolism as a result of the clot detaching from the vein wall and blocking the pulmonary artery. The major signs of pulmonary embolism include dyspnea and chest pain. Postpartum patients are carefully monitored for signs and symptoms of infection during this period.
Common infections that may occur during the postpartum period include:. Hemorrhoids are common in late pregnancy 7. The postpartum period is a time of joy and satisfaction for most women and their families. In order to ensure that these mothers are off to a healthy and happy start with their newborns, nurses must be prepared to assess, intervene, and teach during this time.
Most hospitals and birthing centers provide guidelines for nurses providing postpartum care. Heidi Crean is a nursing instructor in the RN program at Mendocino College in Ukiah, California, where she teaches fundamentals of nursing along with obstetric and pediatric nursing. She also works as a per diem labor and delivery and postpartum nurse in the Family Birth Center and previously worked in the med-surg department at Adventist Health Ukiah Valley.
Her previous education includes a BS in chemistry and a Doctor of Chiropractic degree. She has taught maternity nursing, community health nursing, trends and issues in nursing, and nutrition, and enjoys teaching nursing students both in the classroom and online.
Sign up for our newsletter email list and like us on Facebook and Instagram to be among the first to know about all our special discounts and offers! Wild Iris Medical Education, Inc. In , we began offering online accredited nursing continuing education courses and since then have expanded to provide CEUs for occupational therapists, physical therapists, paramedics, EMTs, and other healthcare professionals.
High-quality, accredited, evidenced-based continuing education courses in an easy-to-use format designed for learning, from Wild Iris Medical Education. We've been providing online CE since Sign In Create Account. Postpartum Physiologic Changes Immediately after delivering, women experience massive shifting as the body returns to its pre-pregnant state.
Postpartum Psychological Changes Bonding , sometimes referred to as attachment, between mothers and infants is affected by a multitude of factors, including socioeconomic status, family history, role models, support systems, disturbed sleep, cultural factors, and birth experiences.
Malattachment behaviors vary and can include: Refusing to look at the infant Refusing to touch or hold the infant Refusing to name the infant Negative comments about the infant Refusing to respond or responding negatively to infant cues e. Routine Postpartum Assessment and Patient Education Primary responsibilities of nurses in postpartum settings are to assess postpartum patients, provide care and teaching, and if necessary, report any significant findings.
The fundus continues to descend into the pelvis at the rate of approximately 1 cm or finger-breadth per day and should be nonpalpable by 14 days postpartum. The bowel is assessed for: Bowel sounds Return of bowel function Flatus Color and consistency of stool Prescribed stool softeners or laxatives are administered as needed to treat constipation and ease perineal discomfort during defecation.
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