Leopold's maneuver is a maneuver to determine fetal position, lie, flexion and

attitude.

performed in 24 weeks or 6 months.

4 leopold's maneuver

lm1: fundal grip

Fingerpalms used to palpate fundus (top of abdomen)

lm2: umbilical grip

Left and right side of the abdomen

lm3: pawlicks grip

Wiggle and floating the presenting part so the baby is not connected to the
pelvic floor.

lm4: pelvic grip

to palpate if the presented part has flexed or extended part. to identify

presentation

presentation

Occiput? vertex presentation

Head presentation
brow presentation
chin presentation
face presentation

lm1-3: nurse body faces mother's face

lm4: nurse body faces mother feet

rub hands: friction to warm

cold hands causes uterine contractions

dorsal recumbent

Cephalic presentation
Breach presentation

soft and round: bottocks

flat: fetal back
irregular size/shape: extremities
Hard and round: fetal head

Fetal heart tone - can only be heard once fetal back has been located

*divide mother's abdomen into four quadrant

Uses doppler fetal monitor or stethoscope
lubdub sound beware of swishing sound (uterine souffle)
as well as funic souffle (blood that flow in the umbilical cord)
120 - 160 fht - indicates that baby's heart rate will be normal once
delivered

Fundal/fundic height
 Linea alba
Symphisis pubis
navel
?

reseta:
ferrous sulfate
ascorbic acid (FOR ENHANCED ABSORPTION)
vitabone (CALCIUM)

Tetanus toxoid (IMPUSH) 0.5 ml as early as 5 months.

IM is deltoid muscle:
Principle of injection: anatomy
Acromion process 3-4 fingers below (Injection site)
90 degrees
Gauge 23 for normal
Disinfect injection site
z-track method before injection

hold the hub of the syringe when introducing medication

use disposable tray for sharps

oral glucose tolerance test

blindshot
done after laboratory testing.

OPD form:
past medical history, only 1 time consultation area

Family history

lmp last mentrual period

expected date of confinement: Naegele's rule: estimated due date
lmp- january - march +9 months +7 days +0 years
lmp - april - December - -3 months+ 7 days + 1 years

Age of gestation =

gravidity
parity number of births
age of viability 20 weeks
term - 37 weeks - 42 weeks
pre term 20 weeks - 36 weeks
abortion 19 weeks below
l - living children

EINC - essential intrapartum newborn care

spraying of betadine
crowning - babies' head visible
actual assist supporting
Laceration degrees
1st degree laceration: skin
2nd degree laceration: skin and muscles
3rd degree laceration: skin, muscles, and anal sphincter
4th degree laceration: skin, perineal muscles, anal sphincter, anus
Primigravid: first
Multigravid: 2 to 5
Grand multigravid: more then 5

Perineal support: proper pulling of crowned head of baby

Under normal positioning of the baby. turn according to the anterior shoulder, pull
down, then up for posterior shoulder then baby slides

care:
immediate drying 20-30 sec
Skin-to-skin contact to promote bonding - prone position baby for breastfeeding
cues. sucking reflex
Proper cord clamping and cutting
Non-separation of baby from mother ad breastfeeding separation.

Oxytocin - uterine contraction, prevents vaginal bleeding for parents

Placenta - traction/ kelly forceps
if there are contractions, there is release

countertraction to prevent the uterus from inverting

Umbilical cord

Wharton's jelly from base to abdomen of

Normal cotyledons: 12 to 15 lobules

amnion

Schultz mechanism: "SHINY"

Duncan mechanism: "DIRTY"

Signs of placental separation:

1. lengthening of the chord
2. Sudden Gushing of the blood
3. Calkilns sign (change of the uterus) change of shape from oval to globular.
discoid to ovoid
4. the uterus rises in the abdomen (contraction) when contract there will be
released.
4. Presence of the placenta in the vaginal opening.

Repair: stitch skin

Anesthesia: lidocaine.

anthropometric measurements/ vital statistics in newborn

Birth length:
Head circumference:
Chest circumference:
abdominal circumference:
(Naked except for bonnet) measures the contour
Erythromycin/theramycin ointment for eyes (SOP)
(opthalmia neonatorum/ eye infection)
inner to outer canthus of the eyes (application)

vaccines hepa B right vastus lateralis, vit. k left vastus lateralis

atony, failure of the uterus to contract