Uterine abdominal cervical assessment

Question 1

Lie

Answer 1

• Relationship of fetal spine to maternal spine

- Longitudinal, transverse, oblique

Question 2

Presentation

Answer 2

Part of fetus presenting at the pelvic inlet

• 96% cephalic
  a. vertex
  b. sinciput (median vertex)
  c. brow
  d. face
• 3-4% breech
  a. complete
  b. incomplete
  c. frank
  d. footling
• shoulder presentation

Question 3

Attitude

Answer 3

• Relationship of fetal parts to one another and the effect that relationship has on the vertebral column
• Flexion or extension of fetal parts

Question 4

Position

Variety

Answer 4

Position - Relationship of the presenting part to the left or right side of the maternal pelvis

Variety - Relationship of the presenting part to the anterior, posterior, or transverse portion of the pelvis

• LOA, ROA, LOP, ROP

Question 5

Leopold Maneuvers

Answer 5

Step 1: Determine Lie
Step 2: Determine orientation (where is fetal back?)
Step 3: Presentation and engagement
Step 4: Variety, flexion and engagement

Question 6

Chadwick’s sign

Answer 6

Bluish discoloration of cervix, vagina, labia d/t increased blood flow, can be observed as early as 6-8 weeks after conception

Question 7

Goodell’s sign

Answer 7

Indication of pregnancy - softening of vaginal portion of cervix from increased vascularization

Question 8

Hegar’s sign

Answer 8

• Softening of lower uterine segment above cervix

- Onset approx 6 weeks EGA

Question 9

Pelvic Outlet (bituberous diameter)

Answer 9

2 triangular planes with a common base (like a 2D diamond with a fold in it), symphysis pubis to B/L ischial tuberosities, then second triangle is along the transverse line from tuberosities to the lowermost part of the sacrum (sacrococcygeal joint); determine size by assessing the pubic arch and intertuberous diameter (11cm)

AP diameter of outlet ~9.5-11cm

Question 10

Diagonal conjugate

Answer 10

11.5cm-12.5

Question 11

Transverse of inlet

Answer 11

13.5cm

Question 12

Interspinous (transverse between ischial spines)

Answer 12

10cm

-assess if there is room midpelvis

Question 13

Obstetrical conjugate

Answer 13

10.5cm

Question 14

Gynecoid pelvis

Answer 14

round, wide opening at inlet. most favorable for childbirth

-can fit 3 fingers for assessment of pubic arch

Question 15

Android pelvis

Answer 15

Heart shaped at inlet. Tailbone and ischial spines point in toward pelvic space, difficult to let babies out
-can fit 2 fingers, sharp pubic arch

Question 16

Anthropoid pelvis

Answer 16

Denser bones, “U” shaped pubic arch (can fit 2 fingers), lots of room posterior

Question 17

Platypelloid pelvis

Answer 17

Wide transverse, narrow AP

-can fit 3 fingers,w wide pubic arch