Antepartal Assessment Flashcards
For Filipino women to have full access to health services
towards making their pregnancy and delivery safer
National Safe Motherhood Program
is committed to provide rational and responsive policy direction to its local government partners in the delivery of quality maternal and newborn health services, with integrity and accountability using proven and innovative approaches
National Safe Motherhood Program
On average, ________ babies were born daily, which translates to _____ babies born per hour or approximately ______________ babies born per minute.
4177;174; three (3)
Refers to the assessment done with the client (expectant mother) from the time of conception to the onset of labor.
Antepartal Assessment
Components of Antepartal Assessment:
Measurement of Fundic Height
Leopold’s Maneuver
Measurement of Fetal Heart Tone
To help determine the position and lie of the fetus, which in conjunction with correct assessment of the shape of the maternal pelvis can indicate whether the delivery is going to be complicated, or whether a caesarean section is necessary.
Leopold’s Maneuver
materials needed for Leopold’s Maneuver
Stethoscope
Tape Measure
- is a measure of the size of the uterus
- used to assess fetal growth and development during pregnancy
Fundal Height or McDonald’s Rule
The fundal height is determined by measuring the
distance from the pubic symphysis to the highest part of the uterus
At about ______________ of pregnancy, the uterus becomes __________ as a ___________________ over the ______________________
12 to 14 weeks; palpable; firm globular sphere; symphysis pubis
It reaches the _______________________and the
_____________________, and then often returns to
about ___________________ because of __________________________________
umbilicus at 20 to 22 weeks ; xiphoid process at 36 weeks; 4cm below the xiphoid; “lightening” at 40 weeks
If a woman is past 12 weeks of a pregnancy,
palpate the fundus location, measure the fundal height
Fundic height (cm) is equal to
AOG
12 weeks
fundus just above pubic bone
36-38 weeks
fundus usually right up under sternum
40 weeks (term)
fundus drops below 38-week level as presenting part drops down into pelvis
Fetal heart sounds can be heard as early as the _________________________ of pregnancy by the use of an ____________________________
10th week to 11th week; ultrasonic Doppler Technique
uses a thin wire (electrode) put on your baby’s scalp the ____ runs from the baby through the cervix
Transvaginal UTZ
Internal FHT Monitoring
Transvaginal UTZ
External FHT Monitoring
Doppler UTZ
Stethoscope
Fetal Heart Monitor
A systematic method of observation and palpation to determine fetal presentation, position, lie and attitude
Leopold’s Maneuver
Leopold’s Maneuver is preferably performed _____________________________ when ____________________________________
after 24 weeks gestation; fetal outline can be palpated
is the length of the fetus
Longest diameter (axis)
Location of apparent fetal movement
the location of the activity most likely reflects the position of the feet
Fetal Position
Cephalic
Transverse
Frank Breech
Complete Breech
Twins
Refers to the relationship between the long axis of the fetus with respect to the longest axis of the mother.
Fetal Lie
- Best presentation
- 28-week gestation
- 6-7 cm dilated
Longitudinal Lie Vertex Presentation
Fetal Lie
Longitudinal Lie Vertex Presentation
Longitudinal Lie Breech Presentation
Transverse Lie Presentation Vertex Presentation
Maneuvers
1st maneuver: fundal grip
2nd maneuver: umbilical grip
3rd maneuver: Pawlick’s grip
4th maneuver: pelvic grip
CARDINAL RULE:
Instruct woman to empty bladder first.
may stimulate uterine contractions.
Cold hands
During the first three maneuvers, stand __________________. For the last maneuver, stand _______________________.
facing the patient; facing patient’s feet
This assessment is done to a client (expectant mother) from the time of conception to the onset of labor
antepartal assessment
to assess fetal growth and development during pregnancy.
Measurement of Fundal Height
to determine fetal presentation and position.
Leopold’s Maneuver
to assess fetal health condition
Measurement of Fetal Heart Sound
EQUIPMENT
a. Tape measure
b. Stethoscope
Place woman in a _______________________,
supine with knee flexed to relax abdominal
muscles. Place a small pillow under the head for
comfort
dorsal recumbent position
Fundal measurement should approximately equal number of weeks gestation; measurements may vary by __ cm;
2
The longest diameter (axis) is the length of the fetus. The location of activity most likely reflects the position of the _________
feet
This maneuver determines whether fetal head or breech is in the fundus.
1st maneuver
Place both hands on the fundal area and palpate. Determine _______________________________________.
consistency, shape, and mobility
hard, round, ballotable
Head –
– soft, globular, and nonballotable
Buttocks
MOVES INDEPENDENTLY OF THE BODY
HEAD
moves
only in conjunction with the body.
breech
This maneuver locates the back of the fetus.
2nd maneuver
smooth, hard, resistant
surface
back
a number of angular nodulations
knees and elbows
This maneuver determines the part of the fetus at the inlet and its mobility.
3rd maneuver
This maneuver determines fetal attitude and
degree of fetal extension into the pelvis
4th manuever
Place fingers on both sides of the
uterus approximately __ inches above
the__________________ , pressing
downward and inward in the direction
of the birth canal. Allow fingers to be
carried downward.
2; inguinal ligaments
