Self-Assessment Questions (SAQs) for Study Session 10

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below Case Study 10.1. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

Case Study 10.1  Abebech

Abebech is a pregnant woman, whose duration of gestation based on her last normal menstrual period (LNMP) is six months. When you examine her, you can feel that the fundus is four finger-widths above her bellybutton and you can hear a fetal heartbeat clearly.

SAQ 10.1 (tests Learning Outcomes 10.1 and 10.2)

  • a.What is your assessment of the gestational age of Abebech’s baby using fundal height measurement?
  • b.How many centimetres would Abebech’s abdomen measure from her pubic bone to the top of her uterus in order to confirm your fundal height measurement?


  • a.The gestational age based on the fundal height measurement is seven months.
  • b.If Abebech is really seven months pregnant, you would expect her abdomen to measure about 28 cm from her pubic bone to the top of the uterus, i.e. approximately one centimetre for each week of pregnancy dated from the LNMP. Remember the measurement may range from 26-30 cm.

SAQ 10.2 (tests Learning Outcome 10.3)

Is the gestational age of Abebech’s baby based on fundal height measurement consistent with the gestational age calculated from her LNMP?


The gestational age based on fundal height is one month more than expected from the date of the LNMP. Therefore, the uterus is bigger than expected from the date of the LNMP.

SAQ 10.3 (tests Learning Outcome 10.4)

What possible explanations can you give for your findings in Abebech’s case, and what actions should you take?


The uterus may be bigger than expected because the date of the LNMP may be incorrect, and Abebech is really seven months pregnant. This is not a problem, but it is important to investigate other possible explanations. For example, she may have too much amniotic fluid (water) surrounding the baby in the uterus; you should refer her to a health facility where she can have an ultrasound examination to find out if this is the problem. Or she could have a twin pregnancy. You can hear one fetal heartbeat clearly, so get someone else to help you listen to Abebech’s abdomen to see if you can hear two fetal heartbeats. If you suspect she is having twins, refer her to the nearest health facility.

Summary of Study Session 10