Clinical skills; pregnant abdominal exam Flashcards
What are you assessing in inspection of a pregnant abdomen?
Foetal movements
Size appropriate to gestation, multiple gestation, polyhydramnios, uterine fibroids, foetal lie, parity
Shape; OP position
Skin changes, previous pregnancies, scars
Bruising or trauma to abdo
What is fundal palpation used for?
Assess gestation (FSH) Indicates foetal lie and presentation
What is lateral palpation used for?
Identify foetal position and confirm lie
What is pelvic palpation used for?
Determine presentation, lie and engagement
What are the different types of lie of a baby?
Longitudinal Cephalic Breech Oblique Transverse
What is the denominator for presentation?
Occiput = vertex Breech = sacrum Face = mentum
How is foetal heart rate assessed?
Sonicaid
Pinnard stethoscope
Listen for 1 min, exclude maternal pulse
Acknowledge HR, strength and irregularities
What is the lie of a baby?
The lie is the relation of the longitudinal axis of the foetus to the longitudinal axis of uterus
What is the vertex?
Area on the foetal head delineated by the anterior and posterior fontanelles and parietal eminences
What is presentation?
Leading part of the foetus which occupies the lower pole of the uterus
What is the position of the foetus?
Relation to the denominator of the presenting part to the quadrants of the maternal pelvis
Cephalic presentation = occiput
Breech = sacrum
E.g. right occipito anterior (ROA)
What is the station?
Location of the presenting part of the foetus in the birth canal; designated as -5 to -1 according to the number of cm above ischial spines
0 when at plane
+1 to +5 when below ischial spine
What is engagement?
Foetus is engaged if the widest part has passed through the pelvic inlet
What is caput?
Oedema formed by the tissue overlying the foetal skull during vaginal birthing process
What are the 4 steps to abdominal exam?
Into and consent
Inspection
Palpation
Auscultation
