Leopold's Maneuver | Return Demonstration
Summary
TLDRIn the video, Sripayna Aquino Maranga demonstrates Leopold's maneuver, a non-invasive method used to determine the position and engagement of a fetus in the uterus after 36 weeks of gestation. The procedure involves four specific maneuvers to palpate the uterus and locate the fetal back and heart tones. The video provides a step-by-step guide, emphasizing the importance of patient comfort, proper handwashing, and infection control. The outcome of the demonstration indicates a cephalic presentation with the baby's head engaged, ideal for labor, and a normal fetal heart rate of 125 beats per minute.
Takeaways
- 🤰 Leopold's maneuver is a systematic palpation technique used to determine the position and presentation of a fetus in the uterus.
- 👩⚕️ It is typically performed after 36 weeks of gestation to prepare for labor and assess the need for a cesarean section.
- 🧼 The procedure requires hand washing and preparation of equipment such as a pillow, towel, and stethoscope to ensure hygiene and comfort.
- 🛌 The patient is positioned supine with a pillow under her head and a towel under her hip to facilitate the examination.
- 🤲 The maneuver consists of four steps: fundal grip, umbilical grip, pollux grip, and pelvic grip, each revealing different aspects of fetal position and engagement.
- 👶 The fundal grip helps to identify if the fetal head or breech is in the upper part of the uterus.
- 🔍 The umbilical grip involves palpating the lateral uterine surface to locate the fetal back or extremities.
- 🤝 The pollux grip is used to determine if the fetal head has engaged in the pelvis.
- 🔎 The pelvic grip confirms the findings of the pollux grip and identifies the presenting part in the hypogastrium.
- 💓 After the maneuvers, the fetal heart tone is located and listened to for at least one minute to assess the baby's well-being.
- 📝 The procedure concludes with the nurse covering the patient, ensuring comfort, and documenting the findings.
Q & A
What is Leopold's maneuver and why is it performed?
-Leopold's maneuver is a systematic palpation technique used to determine the position, presentation, and engagement of the fetus inside the uterus. It is performed after 36 weeks of gestation to help prepare for labor and to assess the need for a cesarean section.
What are the necessary equipment and preparations before performing Leopold's maneuver?
-The necessary equipment includes a pillow, a towel, and a stethoscope. Preparations involve hand washing to prevent infection and ensuring the patient's comfort by having her void before the procedure.
Why is it important to void before Leopold's maneuver?
-Voiding before the maneuver is important as an empty bladder promotes comfort and allows for a more productive examination. A distended bladder can obscure the fetal contour and may slightly deviate the uterus.
How does the patient need to position herself during Leopold's maneuver?
-The patient should be positioned supine with one pillow under her head and a flexed knee, with a towel placed beneath her hip to displace the uterus off the inferior vena cava and aorta, preventing supine hypotensive syndrome.
What is the purpose of the fundal grip in Leopold's maneuver?
-The fundal grip is the first maneuver, where the uterine fundus is palpated to determine which part of the baby is at the upper part of the uterus, such as the fetal head or breech.
How does the umbilical grip help in Leopold's maneuver?
-The umbilical grip involves palpating the lateral uterine surface to determine the fetal back or extremities by applying gentle but deep pressure.
What is the purpose of the pollux grip in the maneuver?
-The pollux grip is used to grasp the lower uterine segment and determine if the fetal head is engaged, providing information about the baby's position in the birth canal.
What does the pelvic grip reveal during Leopold's maneuver?
-The pelvic grip is performed to confirm the findings of the pollux grip and to determine the presenting part in the hypogastrium of the mother, as well as the fetal head position (flexed or extended).
Why is it important to locate the fetal back and listen for the fetal heart tone after the maneuvers?
-Locating the fetal back and listening for the fetal heart tone are important to confirm the baby's position and to ensure the baby's well-being, with a normal heart rate being around 120-160 beats per minute.
What is the significance of the cephalic position mentioned in the script?
-A cephalic position indicates that the baby's head is at the lower part of the uterus and is engaged, which is the ideal position for labor, suggesting a potentially easier delivery.
What is the normal fetal heart rate and what does it indicate?
-A normal fetal heart rate is between 120-160 beats per minute. In the script, a rate of 125 beats per minute indicates that the baby's heart rate is within the normal range, suggesting good fetal health.
Outlines
🤰 Introduction to Leopold's Maneuver
The video script introduces Leopold's maneuver, a non-invasive method used to palpate the gravid uterus and determine the position and presentation of the fetus. It is typically performed after 36 weeks of gestation to prepare for labor. The narrator, Sripayna Aquino Maranga, prepares by gathering necessary equipment such as a pillow, towel, and stethoscope, and emphasizes the importance of hand washing to prevent infection. The patient is greeted, and consent is obtained for the procedure. The patient is instructed to void to ensure comfort during the examination, as a full bladder can affect the accuracy of the maneuver. The patient is then positioned supine with a pillow under her head and a towel under her hip to prevent supine hypotensive syndrome.
👶 Performing Leopold's Maneuver
The script details the steps of performing Leopold's maneuver, which includes four specific grips: the fundal grip to identify the fetal head or breech at the fundus, the umbilical grip to locate the fetal back or extremities, the pollux grip to check for engagement of the fetal head, and the pelvic grip to determine the presenting part and fetal position. The procedure is conducted with the patient's comfort in mind, and the area of examination is exposed only as needed. The narrator explains each step to the patient and performs the maneuvers gently. After the maneuvers, the fetal back is located, and the fetal heart tone is listened to for at least one minute. The procedure concludes with the patient being covered and the findings discussed, which in this case indicate a cephalic presentation with the fetal head engaged, an ideal position for labor. The fetal heart rate is found to be normal at 125 beats per minute. The script ends with the narrator offering to answer any questions and performing hand washing and documentation of the findings.
Mindmap
Keywords
💡Leopold's Maneuver
💡Gravid Uterus
💡Fetal Position
💡Presentation
💡Engagement
💡Supine Hypotensive Syndrome
💡Fundal Grip
💡Umbilical Grip
💡Pollux Grip
💡Pelvic Grip
💡Fetal Heart Tone
Highlights
Introduction to Leopold's maneuver as a non-invasive method to determine the position and presentation of the fetus.
Leopold's maneuver is performed after 36 weeks of gestation to prepare for labor.
The procedure helps in deciding if a cesarean section is safer.
Preparation includes a pillow, towel, stethoscope, and hand washing to prevent infection.
Introduction of the student nurse and the patient, establishing rapport.
Explanation of the purpose of Leopold's maneuver to the patient.
Request for patient's consent and comfort during the procedure.
Instructions for the patient to void to ensure comfort and accurate examination.
Positioning the patient for the examination to prevent supine hypotensive syndrome.
Beginning the first maneuver, the fundal grip, to determine the upper part of the fetus.
Differentiating between the fetal head and breech through palpation.
Proceeding with the second maneuver, the umbilical grip, to find the fetal back or extremities.
The third maneuver, the pollux grip, to check for fetal engagement.
The fourth maneuver, the pelvic grip, to confirm findings and determine the fetal position.
Locating the fetal back and listening for the fetal heart tone.
Completion of the procedure and covering the patient for comfort.
Findings shared with the patient: baby's position and heart rate.
Confirmation of the baby's cephalic position and engagement, ideal for labor.
Normal fetal heart rate of 125 beats per minute.
Offering the patient an opportunity to ask questions post-procedure.
Concluding the procedure with hand washing and documentation of findings.
Transcripts
[Music]
hello everyone i am sripayna aquino
maranga and today i am going to perform
leopold's maneuver return demonstration
leopold's maneuver is used to
systematically palpate the gravid uterus
it is an easy to perform non-invasive
method
to determine the position presentation
and engagement of the fetus inside the
uterus
lupus maneuver is done after 36 weeks
gestation
to help the expectant mother and the
healthcare provider
be better prepared for the labor
and it also helps in determining if it
is
much safer to perform cesarean section
prior to the conduct of the procedure i
have prepared
the necessary equipments needed which
includes
a pillow a towel and a stethoscope
next i have performed hand washing to
protect my patient
and myself as well from infection and
cross contamination
good morning ma'am i'm shakina miranda
your student nurse for today and
may i see your stand please take your
complete name
and your birthday please okay
thank you and how would you like me to
call you today ma'am
all right okay so ma'am today we'll be
doing the leopold's maneuver it is an
easy method
which we use to determine the um
position of your baby inside your uterus
okay so later what i'm going to do is to
feel your abdomen and add a little
pressure so that i can feel
and determine the position of your baby
will that be all right okay
so will it be fine if i close the door
so no one from
outside will be able to disturb you
while we're doing the procedure
okay
okay ma'am so before we begin i
encourage you to void first
so that later you won't feel
uncomfortable
okay
an empty bladder promotes comfort and
allows for a more productive
examination on the other hand a
distended bladder
may obscure the fetal contour and may
slightly deviate
the uterus okay ma'am so you're back
you're done voiding
all right um i need you to lie down and
slightly flex your knee
and i need you to turn to your side a
little
so that i can place a towel underneath
your hip
okay
[Music]
position the patient supine with one
pillow
under her head and a flex
knee would relieve the tension in the
abdominal musculature
and placing a towel beneath the
patient's hip
will displace the uterus off of the
inferior vena cava and the aorta
thus preventing supine hypotensive
syndrome okay
so now we're going to begin i'll be
needing to expose your abdomen
[Music]
okay to begin with the procedure
expose only the area of examination
and if right-handed stand at the
patient's right side
and now i am going to proceed with the
first maneuver which is called
the fundal grip now face the patient
and palpate the
uterine fundus to determine which part
of the baby is at the
upper part of the uterus
it may be the fetal head or the bridge
the fetal head
feels round hard
freely movable and bloatable while
reach feels like feel
softer and nodular
okay now i am going to proceed with the
second maneuver which is called
the umbilical grip what i'm going to do
is
to palpate downwards on the lateral
uterine surface
and determine the fetal back or fetal
extremities
okay apply a gentle but deep pressure
and all right that's it now proceeding
to the third maneuver which is
called the pollux grip and
to do this i am going to place my hand
over the synthesis fuel this
grasp the lower uterine segment
with my thumb and fingers
and
determine if if engagement has already
occurred
all right so now i'm going to proceed
with the fourth maneuver
which is called the pelvic grip this is
done to determine the
findings of the third maneuver as well
as determine the presenting
part that is in the hypogastrium of the
mother
and also determine the cetalic
prominence
so if prominence is at the same side
as of the fetal extremities
then the head is flexed
but if the prominence
is of the same side as of the back
then the head
is extended
[Music]
okay now that we're done with the
maneuvers we are now going to locate the
fetal back again and listen for the
fetal heart
tone okay ma'am so we're done with
the palpation of your abdomen i am not
going to listen for
um your babies hurt me okay
locate the fetal heart tone and listen
for it for at least one minute
okay now so when we're done with the
procedure
i am going to cover you up now
okay so are you comfortable
all right so after doing the procedure
um i have determined that your baby is
at your right side
and that your baby is in
um cephalic position which means the
head of the baby is
at the lower part of your uterus and
it is already engaged this is an ideal
position
of the baby for labor
also when i was listening for your
baby's heart
sound i have counted it and it is in
125 beats per minute and
that is normal okay
so do you have any questions
okay thank you doing the procedure
proceed
to performing hand washing and
the documentation of the findings
you
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