Abdominal Examination in Pregnancy
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Questions and Answers

What is the primary purpose of the third maneuver, Pawlick's Grip, in assessing fetal position?

  • To gauge the maternal comfort level during examination
  • To identify the presenting fetal part above the inlet (correct)
  • To determine the direction of fetal movement
  • To assess the size of the fetal head

How can the fetal back be distinguished from the extremities during examination?

  • The back is always located in the lower abdomen
  • The back feels firm and smooth, while extremities feel irregular (correct)
  • Both should feel the same regardless of fetal position
  • The back feels irregular, while extremities feel smooth

In the pelvic grip maneuver, what does increased resistance to finger descent indicate?

  • The fetal head is extremely flexed
  • The presenting part is engaged in the birth canal
  • The fetus is in a transverse position
  • The brow of the fetus is located on that side (correct)

Why is the two-handed approach preferred over Pawlick's Grip in assessing fetal position?

<p>It is more comfortable for the mother (D)</p> Signup and view all the answers

What should one expect to feel if the fetal head is extended during the pelvic grip maneuver?

<p>The occiput on the same side as the fetal back (D)</p> Signup and view all the answers

What is indicated by a dark brown line from the umbilicus to the symphysis pubis during pregnancy?

<p>Linea negra (C)</p> Signup and view all the answers

In the context of fetal lie, which term describes when the fetus lies across the mother's longitudinal axis?

<p>Transverse lie (A)</p> Signup and view all the answers

What is the primary reason for instructing the mother to empty her bladder before an abdominal examination?

<p>To enhance comfort and accuracy of fundal height measurements (B)</p> Signup and view all the answers

What does the first Leopold's maneuver primarily assess?

<p>Fetal position and presenting part (A)</p> Signup and view all the answers

Which piece of equipment is specifically used to auscultate fetal heart sounds?

<p>Pinard fetoscope (B)</p> Signup and view all the answers

Which skin condition during pregnancy is characterized by silver or red patches due to over stretching?

<p>Striae gravidarum (A)</p> Signup and view all the answers

What position should the mother be in during the abdominal examination to reduce the risk of supine hypotension?

<p>Supine with knees slightly flexed and separated (A)</p> Signup and view all the answers

What is the purpose of the second Leopold's maneuver?

<p>To determine fetal lie (D)</p> Signup and view all the answers

What should a midwife observe for during the inspection phase of the abdominal examination?

<p>The size and shape of the abdomen in relation to the period of amenorrhea (D)</p> Signup and view all the answers

In fetal assessment, what does the term 'presenting part' refer to?

<p>The part of the fetus located at the lowest point in the pelvis (B)</p> Signup and view all the answers

To maintain the mother's privacy during the examination, which area should remain covered?

<p>The legs and pubic area (D)</p> Signup and view all the answers

What is a common method to avoid discomfort to the woman during abdominal palpation?

<p>Employing warm and relaxed hands (A)</p> Signup and view all the answers

What is the correct order of methods used in the abdominal examination?

<p>Inspection, palpation, auscultation (A)</p> Signup and view all the answers

Which maneuver distinguishes between cephalic and breech presentations?

<p>Pawlik's grip (C)</p> Signup and view all the answers

Why is it important for the midwife to explain the procedure to the woman before starting the examination?

<p>To obtain verbal consent and cooperation (C)</p> Signup and view all the answers

Which of the following is NOT considered a method of abdominal examination?

<p>Examination of limb movement (D)</p> Signup and view all the answers

What does the cephalic prominence indicate when evaluating the fetal head's position?

<p>The degree of fetal head flexion (A)</p> Signup and view all the answers

How is engagement of the fetal head defined during the pelvic grip?

<p>When the widest transverse diameter passes through the pelvic inlet (A)</p> Signup and view all the answers

If the cephalic prominence is located on the same side as the fetal back, what does this indicate?

<p>The fetal head is extended (B)</p> Signup and view all the answers

In Leopold's Maneuver, how is the fetal head assessed in terms of engagement?

<p>By estimating how many fifths of the fetal head can be palpated (A)</p> Signup and view all the answers

What is the normal range for the fetal heart rate during auscultation?

<p>110 to 160 beats per minute (A)</p> Signup and view all the answers

When practicing Leopold's Maneuver, where is the best location to auscultate the fetal heart?

<p>Over the fetal back, closer to the cephalic pole (B)</p> Signup and view all the answers

What does it indicate if 3, 4, or 5 fifths of the fetal head are still palpable?

<p>The fetal head has not yet engaged in the pelvis (B)</p> Signup and view all the answers

Which of the following positions of the fetal head indicates a military position?

<p>Fetal head is deflexed (A)</p> Signup and view all the answers

What is the primary objective of defining the procedure during antenatal assessment?

<p>To determine the presentation and position of the fetus. (C)</p> Signup and view all the answers

Which step involves determining the fundal level of the fetus?

<p>Perform abdominal palpation. (C)</p> Signup and view all the answers

When performing the first maneuver, what is the purpose of using palms instead of fingertips?

<p>To ensure a broader contact area for assessment. (D)</p> Signup and view all the answers

What position should the woman be in during the assessment procedure?

<p>Dorsal recumbent position with knees flexed slightly. (B)</p> Signup and view all the answers

In the second maneuver, what is the key aspect being determined?

<p>Fetal back location. (C)</p> Signup and view all the answers

What is the significance of measuring the fundal height from the pubic bone to the fundus?

<p>To assess fetal size relative to gestational age. (C)</p> Signup and view all the answers

Which of the following is NOT a part of the procedure's steps?

<p>Palpating for fetal movements. (B)</p> Signup and view all the answers

What is the first action to take before starting the procedure?

<p>Prepare the instruments needed. (B)</p> Signup and view all the answers

Flashcards

Abdominal Examination Definition

A visual, tactile, and/or audible examination of a woman's abdomen.

Abdominal Examination Objectives

To confirm pregnancy, assess fetal size and growth, locate fetal parts, listen to fetal heart sounds, and detect deviations from normal.

Abdominal Examination Equipment

Pinard fetoscope or sonic fetal heart sound device, and a client record.

Mother Preparation (Empty Bladder)

Instruct the woman to urinate to avoid discomfort and inaccurate fundal height measurements.

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Mother Preparation (Position)

Position the woman on her back with knees slightly flexed to relax abdominal muscles and avoid supine hypotension.

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Abdominal Examination Method - Inspection

Observe the abdomen's shape and size relative to the duration of pregnancy.

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Abdominal Examination Method - Palpation

The act of feeling the abdomen manually to gather information (not further defined in provided text).

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Abdominal Examination Method - Auscultation

Listening to the abdomen to detect sounds (like fetal heart sounds).

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Fetal Lie

Relationship between the fetus's longitudinal axis and the mother's longitudinal axis.

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Fetal Poles

A method to identify the head or buttocks of a fetus

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Longitudinal Lie

Fetus is lying lengthwise in the same direction as the mother's longitudinal axis.

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Transverse Lie

Fetus lies across the long axis of the mother.

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Oblique Lie

Fetus lies at an oblique angle to the mother's long axis.

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Presenting Part

Lowest part of the fetus at the inlet of the pelvis

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Linea Negra

A dark brown line from the umbilicus to the symphysis pubis.

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Striae Gravidarum

Silver or red patches or lines due to overstretching of the skin.

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What does the fourth maneuver determine?

It determines the fetal head's attitude (flexion, deflexion, or extension) and engagement.

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Cephalic prominence & fetal back position: Flexion?

The cephalic prominence is on the opposite side of the fetal back, indicating a well flexed fetal head.

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Cephalic prominence & fetal back position: Extension?

The cephalic prominence is on the same side as the fetal back, indicating an extended fetal head.

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Cephalic prominence & fetal back position: Deflexion?

The examiner's hands reach the fetal head equally on both sides, indicating a deflexed head (military position).

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Engagement of the fetal head: Definition

The widest transverse diameter of the fetal head has passed through the pelvic inlet into the true pelvis.

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Estimating fetal head engagement

The examiner assesses how many fifths of the fetal head can be palpated to determine engagement.

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Engagement: 5, 4, or 3 fifths palpated

Most of the fetal head is still above the pelvis, the widest part has not engaged.

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Engagement: 2, 1, or 0 fifths palpated

The widest part of the fetal head has engaged into the pelvis.

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What part of the fetus is usually found at the maternal inlet?

During the third maneuver of abdominal palpation, the healthcare provider locates the fetal part above the maternal inlet (lower abdomen). This is the part most likely to present first during vaginal birth.

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What does it mean when the fetal head is well-flexed?

If the fetal head is well-flexed, the occiput (back of the head) will be on the opposite side of the fetal back during the fourth maneuver.

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How is the fetal back identified during abdominal palpation?

The fetal back feels firm and smooth, and the arms and legs feel like small irregularities or protrusions.

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What is Pawlick's Grip?

A technique used during the third abdominal palpation maneuver to locate the fetal part above the inlet using one hand, but it's not recommended because it can be uncomfortable for the woman.

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How can you determine the fetal brow during abdominal palpation?

During the fourth maneuver (Pelvic Grip), the healthcare provider moves fingers down the sides of the uterus. The side with the most resistance is where the brow is located, opposite the fetal back.

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What is the purpose of abdominal palpation?

Abdominal palpation during pregnancy helps determine the fetal lie, presentation, position, and engagement. It also helps assess fetal growth and identify potential complications.

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What is the second maneuver in abdominal palpation?

The second maneuver, or 'umbilical grip,' is used to locate the fetal back by palpating the abdomen with gentle, deep pressure on both sides with the palms of the hands.

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What is the fundal height?

Fundal height is the measurement from the top of the pubic bone to the top of the uterus (fundus), measured in centimeters.

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What is the first maneuver in abdominal palpation?

The first maneuver, or 'fundal grip,' helps determine the fetal lie and presentation using both hands to palpate the upper abdomen.

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What is the significance of a 'fetal lie'?

The 'fetal lie' describes how the baby's spine (longitudinal axis) is positioned compared to the mother's spine.

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What is 'engagement' in pregnancy?

Engagement in pregnancy refers to the presenting part (usually baby's head) entering the mother's pelvis.

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What is a 'transverse lie' in pregnancy?

A 'transverse lie' occurs when the baby's spine is perpendicular to the mother's spine, meaning the baby is lying across the abdomen.

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What is 'lightening' in pregnancy?

Lightening occurs when the baby's head drops into the pelvis, resulting in a sense of relief for the pregnant woman.

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Study Notes

Abdominal Examination

  • Definition: A visual, tactile, and/or audible examination of the woman's abdomen.
  • Objectives:
    • Confirm pregnancy
    • Assess fetal size and growth
    • Locate fetal parts
    • Auscultate fetal heart sounds
    • Detect deviations from normal
  • Equipment:
    • Pinard fetoscope or sonic fetal heart sound device
    • Client record
  • Preparation of the Mother:
    • Empty bladder (full bladder makes exam uncomfortable and less accurate fundal height measurements)
    • Lie in supine position (relaxes abdominal muscles)
    • Expose only the area to be palpated, cover remainder of the woman
    • Maintain privacy to aid relaxation
    • Raise shoulders slightly on a pillow, knees drawn up a little

Methods of Abdominal Examination

  • Inspection:
    • Observe abdomen's shape and size in relation to amenorrhea period
    • Check for skin conditions like scars, striae gravidarum
    • Observe for fetal movements
  • Palpation:
    • First Maneuver (Fundal): Palpate fundus for fetal poles (head or breech)
    • Second Maneuver (Lateral): Determine fetal lie (relationship of fetal long axis to mother's)
    • Third Maneuver (Pawlick's): Determine presenting part
    • Fourth Maneuver (Pelvic): Determine attitude of fetal head
  • Auscultation:
    • Listen for fetal heart sounds using a fetoscope or doppler.
    • Best location is over fetal back, closer to the cephalic pole.
    • Normal fetal heart rate is 110-160 bpm.

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Abdomen Examination PDF

Description

This quiz focuses on the techniques and objectives of abdominal examination during pregnancy. It covers preparation for the examination, methods such as inspection and palpation, and the use of specialized equipment. Test your knowledge on confirming pregnancy, assessing fetal growth, and detecting deviations from normal findings.

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