EP110 - Fundus Greater Than Dates in Pregnancy

This podcast is based on clinical scenarios from the official AMC Handbook of Clinical Assessment published by the Australian Medical Council. All cases are used solely for study and discussion. We provide personal learning insights and clinical interpretations to support AMC candidates in developing their clinical reasoning skills. The AMC Handbook is the intellectual property of the Australian Medical Council. To access the official material, please visit the AMC website.

This case focuses on a 26-year-old pregnant woman presenting with a fundus greater than dates, meaning her uterus is larger than expected for her 30 weeks of gestation. The primary purpose is to assess a candidate's ability to diagnose the cause of this uterine enlargement, with a strong emphasis on recognising and managing polyhydramnios, or excessive amniotic fluid. The case outlines a structured approach for the candidate, including gathering relevant history, performing examinations, interpreting investigations, and discussing the diagnosis and potential complications, such as premature labour, with the patient. It highlights key issues, such as understanding the causes of an enlarged uterus and determining the specific cause of polyhydramnios, while also pointing out common errors in candidate performance, including failing to consider polyhydramnios or the possibility of gestational diabetes adequately.

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