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

Chantal Lati

8 Oct 202109:15

Summary

TLDRIn this educational video, Shantalati from BSN2 8-3 demonstrates the proper execution of Leopold's maneuvers and how to measure the fundal height in pregnant women. She explains each step, emphasizing the importance of patient privacy, proper hand hygiene, and patient comfort. Shantalati guides viewers through the four maneuvers to assess fetal presentation and lie, and how to locate the fetal back for auscultation. The video concludes with a reminder to ensure patient comfort and cleanliness, and to document findings.

Takeaways

👩‍⚕️ The video is a tutorial by Shantalati from BSN2 8-3 on performing Leopold's maneuvers and measuring the fundal height in pregnant women.
🧼 Importance of hand hygiene is emphasized to prevent cross-contamination of microorganisms.
🤰 The pregnant woman should urinate before the assessment to avoid discomfort.
🛏️ The patient is positioned supine with a pillow to prevent supine hypotension syndrome.
👐 The first maneuver (fundal grip) assesses the fetal presentation, distinguishing between breech and cephalic presentations.
📏 Fundal height is measured using a tape measure with the zero line above the symphysis pubis.
🔍 The second maneuver (umbilical grip) involves palpating the sides of the uterus to locate the fetal back for auscultation of the fetal heart rate.
🤲 The third maneuver (pollux grip) checks the degree of fetal head engagement by assessing the movement of the head.
👣 The fourth maneuver (pelvic grip) is performed with the practitioner facing the patient's feet, assessing the degree of fetal flexion.
📝 After the assessment, the patient is positioned comfortably, hands are washed, and findings are documented.

Q & A

What is the main focus of the video presented by Shantalati?
-The main focus of the video is to demonstrate how to properly perform Leopold's maneuvers and measure the fundal height of a pregnant woman.
What are the four maneuvers involved in Leopold's maneuver?
-The four maneuvers involved in Leopold's maneuver are the fundal grip, the umbilical grip, the pollux grip, and the pelvic grip.
Why is it important to know the fetal presentation and fetal lie of the baby?
-Knowing the fetal presentation and fetal lie is important for assessing the baby's position within the womb and can help determine if the baby is in a suitable position for delivery.
What is the purpose of measuring the fundal height?
-Measuring the fundal height is done to estimate the size of the uterus and the baby's growth, which can indicate if the baby is developing normally.
Why should the patient urinate before the assessment begins?
-The patient should urinate before the assessment to avoid discomfort during the procedure and to ensure an accurate assessment of the fundal height.
What position should the pregnant woman be in during the assessment?
-The pregnant woman should be in a supine position with slightly flexed knees and a small pillow behind her back to prevent supine hypotension syndrome.
How is the fundal height measured?
-The fundal height is measured using a tape measure with the zero line positioned superior to the symphysis pubis, following the abdominal curve.
What is the significance of the umbilical grip in Leopold's maneuver?
-The umbilical grip is used to determine the fetal back's location, which is important for auscultating the fetal heart rate using a doppler or fetoscope.
What does the pollux grip help to determine?
-The pollux grip helps to determine the degree of engagement of the fetal head, indicating whether the head is engaged or not.
How does the pelvic grip contribute to the assessment?
-The pelvic grip, the fourth maneuver, is used to assess the degree of flexion of the fetal head and to confirm findings from the umbilical grip.
Why is hand washing emphasized before and after the procedure?
-Hand washing is emphasized to prevent cross-contamination of microorganisms and maintain hygiene for both the healthcare provider and the patient.

Outlines

00:00

🤰 Introduction to Leopold's Maneuver and Fundal Height Measurement

Shantalati from Bsn2 8-3 introduces a video tutorial on performing Leopold's maneuver and measuring fundal height in pregnant women. The video begins with the preparation of necessary equipment and ensuring patient privacy. Shantalati greets the patient, verifies her identity, and explains the procedure, which involves four maneuvers to determine fetal presentation and lie. The patient is instructed to urinate and wash hands before the assessment. The video demonstrates the first maneuver, the fundal grip, to assess the fetal presentation, and shows how to measure fundal height using a tape measure. The importance of a comfortable position for the patient and avoiding supine hypotension syndrome is emphasized.

05:01

👶 Continuing Leopold's Maneuver and Patient Comfort

The video continues with the second maneuver, the umbilical grip, to determine the fetal back's location for auscultation of the fetal heart rate. The third maneuver, the pollux grip, assesses the degree of fetal head engagement. The final maneuver, the pelvic grip, confirms the findings from the second maneuver and assesses the degree of fetal head flexion. The video concludes with instructions to ensure the patient is comfortable, to wash hands, and to document any findings. The video ends with a reminder to wash hands and a light-hearted moment with laughter and applause.

Mindmap

Keywords

💡Leopold's maneuver

Leopold's maneuver is a series of four techniques used by healthcare professionals to determine the position of a fetus in the womb. It is crucial for assessing the fetal presentation and lie, which are key factors in determining the course of labor and delivery. In the script, the nurse demonstrates each maneuver to identify whether the baby is in a breech or cephalic presentation, and to locate the fetal back for auscultation of the fetal heart rate.

💡Fetal presentation

Fetal presentation refers to the part of the fetus that is closest to the birth canal. It is an important aspect of prenatal care as it can influence the ease of delivery. In the video, the nurse uses the first maneuver of Leopold's to assess whether the baby is presenting breech (bottom first) or cephalic (head first), which is critical for planning the delivery.

💡Fetal lie

Fetal lie describes the relationship of the fetus to the mother's pelvis, specifically the orientation of the long axis of the fetus relative to the mother's. It is another critical factor in determining the ease of labor and delivery. The script mentions that the Leopold's maneuver helps to ascertain the fetal lie, which is essential for monitoring the baby's position throughout pregnancy.

💡Fundal height

Fundal height is the measurement from the pubic bone to the top of the uterus, reflecting the size of the uterus and providing an estimate of fetal growth. In the video, the nurse uses a tape measure to determine the fundal height, which is an important part of prenatal care to ensure the baby is growing appropriately.

💡Supine position

The supine position is when a person lies flat on their back. In the context of the video, the pregnant woman is asked to lie in a supine position with a pillow for support to prevent supine hypotension syndrome, which can occur when the pregnant uterus compresses major blood vessels, leading to a drop in blood pressure.

💡Supine hypotension syndrome

Supine hypotension syndrome, also known as aorticocaval compression, is a condition that can occur in late pregnancy where the weight of the uterus compresses the inferior vena cava and aorta, potentially leading to decreased blood flow and blood pressure. The script mentions the use of a pillow to prevent this by elevating the woman's upper body slightly.

💡Fetal back

The term 'fetal back' refers to the location of the baby's back within the uterus, which is important for determining the optimal position for auscultating the fetal heart rate. In the video, the nurse uses the second maneuver of Leopold's to palpate the sides of the uterus to locate the fetal back, which is essential for accurate fetal heart rate monitoring.

💡Auscultation

Auscultation is the medical practice of listening to the internal sounds of the body, typically using a stethoscope. In the context of the video, the nurse mentions that once the fetal back is located, a doppler or fetoscope will be used to auscultate the fetal heart rate, which is a standard procedure in prenatal care to ensure the baby's well-being.

💡Fetal heart rate

The fetal heart rate (FHR) is the number of heartbeats per minute of the fetus. A normal FHR ranges from 120 to 160 beats per minute, as mentioned in the script. Monitoring the FHR is crucial for assessing the baby's health and well-being during pregnancy.

💡Pelvic grip

The pelvic grip is the fourth maneuver in Leopold's technique, where the practitioner faces the patient's feet and palpates the pelvis to assess the degree of fetal head flexion and engagement. This is important for understanding how the baby's head is positioned in relation to the mother's pelvis, which can impact the delivery process.

💡Engagement

Engagement refers to the degree to which the fetal presenting part (usually the head) has entered the pelvis. In the script, the nurse uses the pollux grip to determine if the fetal head is engaged, which is significant for predicting the onset of labor and the potential for a vaginal delivery.

Highlights

Introduction to the video on performing Leopold's maneuver and measuring fundal height on a pregnant woman.

Gathering necessary equipment and ensuring patient privacy before starting the procedure.

Introducing oneself and verifying the patient's identity.

Explaining the purpose of the Leopold's maneuver to the patient.

Instructing the patient to urinate to ensure comfort during the assessment.

Demonstrating proper hand washing to prevent cross-contamination.

Positioning the patient for the assessment to avoid supine hypotension syndrome.

Performing the first maneuver to determine the fetal presentation.

Using a tape measure to identify the fundal height of the baby.

Palpating the sides of the uterus in the second maneuver to locate the fetal back.

Determining the fetal heart rate and its importance in fetal health assessment.

The third maneuver, the pollux grip, to assess the degree of fetal head engagement.

The fourth maneuver, the pelvic grip, to assess the degree of fetal head flexion.

Ensuring the patient is in a comfortable position after the assessment.

Emphasizing the importance of hand washing after the procedure.

Recording any unusual findings from the assessment for further evaluation.

Conclusion of the video with a reminder to practice proper hand hygiene.