Summary Labor and Delivery Study Guide In-class activity

Labor and Delivery Study Guide In-class activity The Leopold's Maneuver is used to determine: - 1. number of fetuses 2. presenting part 3. fetal lie 4. fetal attitude 5. degree of fetal descent 6. fetal heart rate's anticipated point of maximum intensity The four parts of Leopold's Maneuver - The Fourth Maneuver: The nurse faces the patient's feet and attempts to locate the cephalic prominence, (brow). Location of this landmark assists in assessing the decent of the presenting part into the pelvis. This maneuver also indicates whether the fetus' head is flexed or distended, (571). Leopold's First Maneuver: - Nurse palpates the upper abdomen with both hands. The nurse is to determine the size, shape, mobility and consistency of the form that is found. - determine fetal lie and presentation, shape, size, etc Leopold's Second Maneuver: - After ascertaining whether the head or the buttocks occupies the fundus, the nurse tries to determine the location of the fetal back and notes whether is it is on the right or the left side of the maternal abdomen. Once the back is located the nurse confirms by palpating the fetal extremities Leopold's Third Maneuver: - Nurse determines which fetal part is lying above the inlet by gently grasping the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand Leopold's Fourth Maneuver: - Nurse faces the patient's feet and attempts to locate the cephalic prominence, (brow). Location of this landmark assists in assessing the decent of the presenting part into the pelvis. This maneuver also indicates whether the fetus' head is flexed or distended Fetal position - Relationship of the landmark on the presenting fetal part to the front, sides or back of the maternal pelvis Fetal presentation - fetal body part that enters the maternal pelvis first. The three possible presentations are cephalic (normal), shoulder, and breech Fetal attitude - Relationship of the fetal parts to one another. Normal fetal attitude is one of moderate flexion of the arms onto the chest and flexion of the legs onto the abdomen (aka General Flexion) Fetal lie: - Relationship of the cephalocaudal axis (spinal column) of the fetus to the cephalocaudal axis of the women. The fetus may be in a longitudinal (normal; parallel to mom's spine) or transverse lie (assoc. w/ shoulder presentation & labor complications) Basic Pelvis Types FAVORABLE for Vaginal Delivery - gynecoid anthropoid Basic Pelvis Types NOT Favorable for Vaginal Delivery - Android Platypelloid Gynecoid: - inlet rounded with all inlet diameters adequate; favorable for vaginal birth Anthropoid: - Inlet oval shape with long anteroposterior diameter; favorable for vaginal birth Android: - Inlet heart shaped with short posterior sagittal diameter; not favorable for vaginal birth Platypelloid: - Inlet oval shaped with long transverse diameters; not favorable for vaginal birth