How to do Obstetric Examination? Leopold Maneuvers | Obs-Gyne Full Course Launched

Summary

Dr. Shanali Chandra guides viewers through an obstetric examination in this educational video. She emphasizes the importance of patient consent and comfort, explains how to correctly position the patient, and demonstrates how to assess fundal height and fetal position. The video covers techniques like Leopold's maneuvers and the significance of fetal heart sounds in determining the baby's presentation. It concludes with an assessment of a term-sized, relaxed uterus with a cephalic presentation in a left occipital anterior position.

Takeaways

• 👩‍⚕️ Always explain the procedure and obtain verbal consent before starting an obstetric examination.
• 💧 Ensure the patient empties her bladder to avoid misinterpretation of uterine size due to a full bladder.
• 🛌 Position the patient comfortably in dorsal supine position with hips and knees slightly flexed and knees wide apart.
• 🤰 Correct any uterine tilt before palpating for fundal height to ensure accurate assessment.
• 📏 Fundal height is assessed by measuring from the pubic symphysis to the top of the uterus, indicating the stage of pregnancy.
• 📐 Use the ulnar border of the hand to palpate and estimate the fundal height, correlating it with pregnancy weeks.
• 🤰 A term-sized uterus is indicated by full flanks, suggesting the baby's body occupies the space as the head engages.
• 🤲 Perform Leopold's maneuvers to determine the position of the fetus, which includes fundal, lateral, and pelvic grips.
• 👶 The fetal heart rate is best auscultated from the fetal back side, which can indicate the position of the fetus.
• 🔍 The final examination conclusion includes the size of the uterus, presentation (cephalic), and position (left occipital anterior).

Q & A

What is the purpose of the video by Dr. Shanali Chandra?

The purpose of the video is to demonstrate and explain the process of obstetric examination.

Why is it important to empty the bladder before an obstetric examination?

Emptying the bladder is crucial as a full bladder can interfere with the interpretation of the fundal height or the size of the uterus, potentially leading to a falsely high estimation.

What position should the patient be in during the examination?

The patient should be in a dorsal supine position with hips and knees slightly flexed and knees wide apart to relax the abdominal muscles.

Why is it necessary to correct the tilt of the uterus before palpation?

Correcting the tilt of the uterus ensures accurate assessment of the fundal height, as the uterus may be tilted towards one side, affecting the measurement.

How is the fundal height estimated during an obstetric examination?

The fundal height is estimated by palpating from the pubic symphysis to the umbilicus and comparing it to standard measurements corresponding to different weeks of pregnancy.

What does the term 'term-sized uterus' refer to in the context of the examination?

A 'term-sized uterus' refers to a uterus that is at the size expected at full term, typically around 38-40 weeks of pregnancy, with the baby's body occupying the flanks.

What is the significance of Leopold's maneuvers in obstetric examination?

Leopold's maneuvers are a series of four grips used to determine the presentation and position of the fetus, which are crucial for assessing the baby's alignment and potential for a vaginal delivery.

How can the position of the fetal heart sound provide insight into the fetal position?

The position of the fetal heart sound can indicate the position of the fetal back, which helps in determining the fetal presentation and position, such as whether it is anterior or posterior.

What does LOA stand for in the context of fetal position, and how is it determined?

LOA stands for Left Occipito-anterior, which is a term used to describe the position of the fetus where the back of the baby is against the mother's left side and the baby's head is facing towards the mother's front. It is determined by palpation and auscultation of the fetal heart sounds.

Why is it important to auscultate the fetal heart rate during an obstetric examination?

Auscultating the fetal heart rate is important to assess the baby's well-being and to determine the position of the fetal back, which can indicate the fetal presentation and position.

What is the significance of the linea nigra and striagravadorum mentioned in the script?

The linea nigra is a dark line that may appear during pregnancy, running from the navel to the pubic bone, and striagravadorum are stretch marks that can appear on the abdomen. They are significant as they are common physiological changes during pregnancy.