LEOPOLD'S MANEUVER AND FUNDAL HEIGHT MEASUREMENT l RETURN DEMONSTRATION (student nurse)

Introduction

This tutorial provides a comprehensive guide on performing Leopold's Maneuver and measuring fundal height, essential skills for student nurses in obstetric care. These techniques help assess fetal position and growth, crucial for monitoring pregnancy.

Step 1: Obtain Informed Consent

• Before initiating any physical assessment, always ask for the patient's consent.
• Explain the procedure clearly, ensuring the patient understands what to expect.
• Maintain open communication throughout the assessment to respect the patient’s comfort.

Step 2: Position the Patient

• Ensure the patient is comfortably lying on their back with their knees slightly bent.
• Use pillows for support as needed to enhance comfort.

Step 3: Perform Leopold's Maneuver

Leopold's Maneuver comprises four distinct palpation techniques to assess fetal position and presentation.

Step 3.1: First Maneuver

• Place your hands on the upper abdomen to identify the fetal fundus.
• Assess the shape and consistency; a firm round mass indicates the head, while a softer mass suggests the buttocks.

Step 3.2: Second Maneuver

• Move your hands down the sides of the abdomen to feel for the fetal back and limbs.
• The smooth, firm surface indicates the back, while small parts indicate limbs.

Step 3.3: Third Maneuver

• Locate the fetal part at the lower pole of the uterus, just above the pubic symphysis.
• Determine if it is the head or buttocks by feeling for the shape and consistency.

Step 3.4: Fourth Maneuver

• Gently palpate the lower abdomen to assess the fetal attitude and degree of extension into the pelvis.
• Be cautious with your palpation to avoid discomfort or harm to the fetus.

Step 4: Measure Fundal Height

• Use a measuring tape to measure the distance from the top of the pubic bone to the fundus of the uterus.
• Ensure the tape is straight and the measurement is taken vertically.
• Record the measurement, which helps estimate gestational age and fetal growth.

Practical Tips

• Avoid deep palpation as it may harm the fetus.
• Always remember to provide reassurance to the patient throughout the assessment.
• Regularly practice these maneuvers in a safe environment to build confidence and skill.

Conclusion

Mastering Leopold's Maneuver and fundal height measurement is crucial for effective prenatal care. Always prioritize patient comfort and consent, and practice these steps regularly to enhance your nursing proficiency. For further learning, consider reviewing anatomy resources and practicing with peers under supervision.