Examination of pregnant abdomen

Question 1

How should the patient be positioned?

Answer 1

Supine if possible or left lateral in late pregnancy

Expose xiphisternum to pubic symphysis

Question 2

What are the steps in this examination?

Answer 2

1) General inspection
2) Inspect pregnant abdomen
3) Palpate for lie, position and engagement
4) Measure fundal height
5) Measure fetal heartbeat

Question 3

What is the lie? Give examples of types of lie.

Answer 3

Fetuses long axis in relation to the mother

Longitudinal, oblique, transverse

Question 4

What is presentation? Give examples.

Answer 4

The part of the fetus in the lower pole of the uterus

Head-cephalic, Bum= breech, shoulder, face, brow, footling breech etc

Question 5

What is position? Give examples and explain!

Answer 5

Position of fetal head in relation to the pelvis
Occiput anterior=face is turned down towards mother’s bum
Occiput posterior=face is turned upwards, with back of head facing mother’s bum
LOA, ROA, LOT, ROT, LOP, ROP
Breech positions e.g. Sacrum anterior etc

Question 6

What is engagement and how is it recorded?

Answer 6

How much of the baby’s head is in the pelvis

Measured in 5ths- when 2/5ths or less of the head is palpable in the abdomen it is engaged