![]() ![]() Push gently with one hand while holding the other hand firm to steady the uterus alternate the pressure between your two hands. Place your hands on either side of the middle of her abdomen. ![]() (Source: WHO, 2008, Managing Prolonged and Obstructed Labour, Figures 7.4 and 7.5, pages 115 and 116) (a) The back of the fetus is towards the front of the mother’s abdomen (b) The back of the fetus is towards the mother’s back. The most common, and the easiest for the baby to be born, is called the vertex presentation.įigure 2.5 Lateral palpation–the second manoeuvre. There are several different cephalic presentations, which you will learn about in Study Session 8. This is cephalic presentation (cephalic means head). If the shapes feel soft and irregular and they don’t easily move under gentle pressure from your hands, then the baby’s buttocks are occupying the fundus (as in Figure 2.4) and it is ‘head-down’. Feel whether the top part of the uterus is hard and rounded or soft and irregular. Use the palms of both hands to palpate on either side of the fundus, with your fingers quite close together (see Figure 2.4). The purpose of palpating the fundus in a woman in labour is to discover how the baby is lying in the uterus. During antenatal care, you should have been measuring the length of the uterus from the mother’s pubic bone to the fundus, and comparing this with the baby’s gestational age to see if it was growing normally. Scarring of the uterus puts her at risk of uterine rupture during the current delivery (as you will learn in Study Session 10).įirst Leopold’s manoeuvre: fundal palpationįundal palpitation means palpating the dome-shaped upper part of the uterus, called the fundus.
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