Abdominal Palpations Flashcards
LAPPED
Lie, Attitude, Presentation, Position, Engagement, Denominator
Lie
Relation of the long axis of the fetal spine to the maternal spine. Lie can be longitudinal, oblique and transverse.
Attitude
Relationship of fetal body parts to each other. Attitudes can be extended, flexed or deflexed.
Presentation
Fetal body part which occupies the lower pole of the uterus. Presentations can be cephalic/vertex (head), brow, shoulder (dorsoanterior or dorsoposterior), face, or breech.
Position
Fetal placement in the uterus, with the dominator of the fetus related to the 6 parts of the maternal pelvis. There are 6 positions; left and right anterior, left and right posterior and left and right transverse.
Engagement
Entry of the presenting part of the fetus into the maternal pelvis which is measured in fifths using finger widths.
Denominator
Point on the presenting part of the fetus in relation to the 6 parts of the maternal pelvis. Can be occipital (cephalic), sacrum (breech) or mentum (face)
Normal Fetal Heart Rate
110-160 bpm
Allowance for difference in gestation and fundal height
2cm
Auscultation
Listening for the fetal heartbeat
Cephalic
The fetal head
Occipit
The back/posterior portion of the fetal head.
Mentum
Chin
The 3 stages of abdominal palpation
Fundal, lateral and pelvic
Fundal Palpation
Finding and palpating the top of the uterus to measure the fundal height.
Lateral Palpation
Palpating the sides of the uterus to determine the lie and position of the fetus and indicate the volume of liquor, tone of the uterus and the movements of the fetus.
Pelvic Palpation
Palpating in the pelvic region to determine the engagement, attitude and denominator of the fetus.
Fundal Mesurement
Measure from the highest point of the fundus to the upper margin of the pupic symphysis.
Gestation fundal height can be measured from
24 weeks onwards
