What finding might indicate intrauterine growth restriction (IUGR) during a prenatal assessment at 26 weeks gestation?

A fundal height measurement of 22 cm at 26 weeks gestation suggests that the fetus is smaller than expected for its gestational age, which is a potential indicator of intrauterine growth restriction (IUGR). Typically, at this stage of pregnancy, the fundal height is expected to be approximately 26 cm, correlating closely with the number of weeks in gestation. A discrepancy of this nature implies that the fetus may not be growing adequately and could be at risk for IUGR, which is characterized by restricted growth within the womb due to various factors, including placental insufficiency, maternal health issues, or genetic conditions.

In contrast, findings such as Leopold's maneuvers indicating a hard round object in the fundus do not directly provide information about fetal growth. Similarly, a weight gain of 6 pounds over four weeks is within a reasonable range for a pregnancy and isn’t indicative of IUGR. Furthermore, an alpha-fetoprotein level that is one-half of normal may suggest certain abnormalities or conditions, but it doesn't specifically indicate IUGR. Therefore, the fundal height measurement is the most relevant indicator in this scenario.