BEstimation of gestational age by uterine size

(1) The nongravid uterus is 3 x 4 x 7 cm. The uterus begins to change in size at 5-6 weeks.

(2) Gestational age is estimated by uterine size: 8 weeks = 2 x normal size; 10 weeks = 3 x normal; 12 weeks = 4 x normal.

(3) At 12 weeks the fundus becomes palpable at the symphysis pubis.

(4) At 16 weeks, the uterus is midway between the symphysis pubis and the umbilicus.

(5) At 20 weeks, the uterus is at the umbilicus. After 20 weeks, there is a correlation between the number of weeks of gestation and the number of centimeters from the pubic symphysis to the top of the fundus.

(6) Uterine size that exceeds the gestational dating by 3 or more weeks suggests multiple gestation, molar pregnancy, or (most commonly) an inaccurate date for LMP. Ultrasonography will confirm inaccurate dating or intrauterine growth failure.

c. Adnexa are palpated for masses.

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