Gestational age relates to the age of an embryo or fetus (or newborn infant).

There is some ambiguity as to

how it is defined:
In embryology, the term "gestational age" is seldom used because it lacks precision. The timing of embryonic
development starts with fertiliation. In mammals, this proceeds through uterine implantation, until
birth.
In human obstetrics, gestational age is often defined as the time elapsed since !" days prior to fertiliation.
This is appro#imately the duration since the woman$s last menstrual period (%&') began. There is
also a further distinction between the calendar gestational age described here, and the developmental
gestational age determined by comparing an embryo or fetus to the average age of others that were at
the same stage of development.
(nless the e#act date of fertiliation is known, counting from %&' has been the common method of
computing gestational age. It involves the assumption that fertiliation in humans typically occurs a consistent
period (!" days) from the onset of the %&'. )lthough this "%&' method" of calculating gestational age is
convenient, other methods are in use or have been proposed.
)ge of *estation
a. +agele,s -ule . calculation of the e#pected date of confinement (/01). 1ount back three months from
the first day of the last menstrual period (%&') then add 2 days. 3ubstitute number for month for easy
computation. /.g., %&' is 3eptember 4.
3eptember is the 5
th
month of the year . 6 7 4 (8(+/)
)dd 2 days to 4 7 !6
/01: 8une !6
b. &c 0onald,s &ethod . determine the age of gestation by measuring from the fundus to the symphysis
pubis (in cm) then dividing by ", e.g., fundic height of !4 cm.9 divided by " 7 " months ):* 7 !4
weeks ):*
c. ;artholomew,s -ule . estimate the ):* using the relative position of the uterus in the abdominal
cavity.
;y the 6
rd
, lunar month, the fundus is palpable slightly above the symphysis pubis.
:n the <
th
lunar month, the fundus is at the level of the umbilicus.
:n the 5
th
lunar month, the fundus is below the #iphoid process.
d. =aase,s -ule . determines the length of the fetus in centimeters.
!. 0uring the !
st
half of pregnancy, s>uare the number of the month (e.g., !
st
lunar month: ! # ! 7
!cm)
?. 0uring the second half of pregnancy, multiply the month by (e.g., 4
th
lunar month: 4 # < 7 6@cm)
e. 8ohnson,s -ule . estimates the weight of the fetus in grams. Aormula: fundic height (in cm) . (in # k),
where:
BkC is a constant, it is always !<<
BnC is 7 !? (if fetus is engaged)
7 !!(if fetus is not yet engaged)
Estimates in Pregnancy
A good preparation for the upcoming labor and delivery prevents life threatening risks to the mother
and the baby. To have an idea when the estimated date of delivery (EDD) is, the nurse should have
knowledge on the different estimates used for pregnant women. These techniues may or may not
e!actly point out the EDD or age of gestation, but it tries to estimate the age of pregnancy and
possible date of delivery for the mother to be prepared.
Nageles Rule
"agele#s rule is used to determine the EDD on the basis of the first day of the last menstrual period
or $%&. To calculate the date of birth in this rule, subtract ' months from the first day of $%& then
add ( days and change the year. )or e!ample the last menstrual period ($%&) began *uly '+, ,+-+.
To determine the EDD follow the following steps.
/ubtract ' months (*une '+, %ay '+, April '+) 0 April '+, ,+-+
Add ( days then change the year 0 April '+ 1 ( (April has '+ days only, thus, adding ( days would
make the EDD %ay () 0 %ay ( (change the year) 0 %ay (, ,+--
Modified McDonalds Rule
2measuring the fundic height in mcdonald3s rule
%cDonald#s 4ule or method is used to determine the age of gestation by measuring from the fundus
(obtaining the fundal height) to the symphysis pubis. The distance in centimeters will determine the
age of gestation from 16-38 weeks. (From Benson and Pernolls handbook of obstetrics and
gnecolog!
Johnsons Rule
*ohnson#s rule is used to estimate the weight of the fetus in grams. To determine this, a standard
formula is used.
)ormula. fundic height in cm 5 n ! k
k is constant, it is always -66
n is -, if the fetus is engaged. 7t is -- if the fetus is not yet engaged.
E!ample.
A fundic height of ,8 cm, and the fetus is not engaged.
,8 cm 5 -- ! -66 0 -( ! -66 0 ,9'6 grams
Bartholomews Rule of fourths
This method estimates the age of gestation relative to the height of the fundus of the uterus above
the symphysis pubis.
:y '
rd
lunar month (-, weeks), the fundus is slightly palpated above the above the symphysis pubis.
:y the 6
th
lunar month (,+ weeks), the fundus is palpable at the level of the umbilicus.
;n the <
th
lunar month, the fundus is at the level of the !iphoid process.
image from womenshealtha"ta.org