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    1.3 Funda Saber 2024 LO 3 Learning Guide

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    Edward Mercader
    MLETQ5

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    1.3 Funda Saber 2024 LO 3 Learning Guide

    Uploaded by

    Edward Mercader
    2 views4 pages
    MLETQ5

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    © © All Rights Reserved

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    MLETQ5

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    2 views4 pages

    1.3 Funda Saber 2024 LO 3 Learning Guide

    Uploaded by

    Edward Mercader
    MLETQ5

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 4

    1.3.

    Computation of EDC & AOG

    • Evaluating: 2

    Determination of Estimated Birth Date


    It is impossible to predict the day an infant will be born with
    a high degree of accuracy. Traditionally, this date was referred
    to as the estimated date of confinement (EDC).
    Because women are no longer “confined” after childbirth, the
    abbreviation EDB (estimated date of birth) or EDD (estimated
    date of delivery) is more commonly used today.
    Fewer than 5% of pregnancies end exactly 280 days from
    the last menstrual period or exactly on this date; fewer than
    half end within 1 week of the 280th day.
    If fertilization occurred early in a menstrual cycle, the
    pregnancy will probably end “early”; if ovulation and fertilization
    occurred later in the cycle, the pregnancy will end
    “late.” Because of these normal variations, a pregnancy ending
    2 weeks before or 2 weeks after the calculated EDB is
    considered well within the normal limit (38–42 weeks).
    Gestational age wheels or birth date calculators that can be
    used to predict a birth date are available, but calculation by
    Nagele’s rule is the standard method used to predict the
    length of a pregnancy (Box 9.4).

    Nagele’s Rule
    To calculate the date of birth by this rule, count
    backward 3 calendar months from the first day of a
    woman’s last menstrual period and add 7 days. For
    example, if the last menstrual period began May
    15, you would count back 3 months (April 15,
    March 15, February 15) and add 7 days, to arrive
    at a date of birth of February 22.

    Estimating Fetal Growth


    McDonald’s rule, a symphysis-fundal height measurement,
    although not documented to be thoroughly reliable, is an
    easy method of determining during midpregnancy that a
    fetus is growing in utero. Typically, the distance from the
    uterine fundus to the symphysis pubis in centimeters is equal
    to the week of gestation between the 20th and 31st weeks of
    pregnancy. Make the measurement from the notch of the
    symphysis pubis to over the top of the uterine fundus as a
    woman lies supine (Fig. 9.9). McDonald’s rule becomes inaccurate
    during the third trimester of pregnancy because the
    fetus is growing more in weight than in height during this
    time. Until then, a fundal height much greater than this standard
    suggests multiple pregnancy, a miscalculated due date,
    a large-for-gestational-age infant, hydramnios (increased amniotic
    fluid volume), or possibly even hydatidiform mole (see
    Chapter 21). A fundal measurement much less than this suggests
    that the fetus is failing to thrive (intrauterine growth restriction),
    the pregnancy length was miscalculated, or an
    anomaly, such as anencephaly, has developed.
    Determining and recording that the fundus has reached
    typical milestone measurements, such as over the symphysis
    pubis at 12 weeks, at the umbilicus at 20 weeks, and at the
    xiphoid process at 36 weeks, are also helpful.

    ASSESSMENT OF FETAL GROWTH AND DEVELOPMENT

    • Fetal growth and development can be compromised if a fetus has a metabolic


    or chromosomal disorder that interferes with normal growth, if the supporting
    structures such as the placenta or cord do not form normally, or if
    environmental influences such as cigarette smoking (the nicotine in cigarettes
    causes fetal growth restriction) or alcohol consumption (alcohol causes severe
    cognitive challenge) interfere with fetal growth. Much information regarding
    whether a fetus is growing and is healthy can be gathered through a variety
    of assessment techniques.

    Estimates in Pregnancy

    1. Estimating EDC/EDD: Expected Date of Confinement/ Expected Date of


    Delivery

    A. Nagele’s Rule

    • To calculate the date of birth by this rule,

     Formula: Count backward 3 calendar months from the first day of a


    woman’s last menstrual period and add 7 days.

     -3 months + 7 days + 1 year

     Example:

    1. For example, if the last menstrual period began May 15, you
    would count back 3 months (April 15, March 15, February 15) and
    add 7 days, to arrive at a date of birth of February 22.

    May 15, 2021


    -3mos + 7days__+1yr_____

    February 22, 2022

    B. Using Fundic Height

     To get accurate results, instruct the mother to first VOID

    1. At symphysis pubis: 12 weeks

    2. At umbilicus: 20 to 22weeks

    3. At xiphoid process: 36 weeks

    2. Estimating Age of Gestation/ Fetal Growth

    B. McDonald’s rule, a symphysis-fundal height measurement, although not


    documented to be thoroughly reliable, is an easy method of determining during
    midpregnancy that a fetus is growing in utero.

    1. Formula for Estimating Age of Gestation in Lunar Months: Fundic Height or FH


    X2 /7

    2. Formula for Estimating Age of Gestation in Lunar Weeks: Fundic Height or FH


    X8/ 7

    3. Typically, the distance from the uterine fundus to the symphysis pubis in
    centimeters is equal to the week of gestation between the 20th and 31st
    weeks of pregnancy. Make the measurement from the notch of the symphysis
    pubis to over the top of the uterine fundus as a woman lies supine.

    • McDonald’s rule becomes inaccurate during the third trimester of pregnancy


    because the fetus is growing more in weight than in height during this time.

    • Until then, a fundal height much greater than this standard suggests multiple
    pregnancy, a miscalculated due date, a large-for-gestational-age infant,
    hydramnios (increased amniotic fluid volume), or possibly even hydatidiform
    mole (see Chapter 21).

    • A fundal measurement much less than this suggests that the fetus is failing to
    thrive (intrauterine growth restriction), the pregnancy length was
    miscalculated, or an anomaly, such as anencephaly, has developed.

    • Determining and recording that the fundus has reached typical milestone
    measurements, such as over the symphysis pubis at 12 weeks, at the
    umbilicus at 20 weeks, and at the xiphoid process at 36 weeks, are also
    helpful.

    A. Formula for Estimating Age of Gestation in Lunar Months:

     Formula: Fundic Height in cm or FH X2 /7

     Example:

     Given fundic height in cm: 20cm

     (20 x2)/ 7

     40/7

     = 5.71 mos. (.71 x 30 to get number of days in a month= 21.3


    days)

     5 months and 21 days

    B. Formula for Estimating Age of Gestation in Lunar Weeks:

     Formula: Fundic Height or FH X8/ 7

     Example:

     Given fundic height in cm: 20cm

     (20x8)/7

     (160)/7

     22.86 wks. (0.86 x 7 days in a week= 6.02 or 6 days

     22 weeks and 6 days

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