GOOD DAY DOCTOR!

I’M MEDICAL STUEDENT CHRISTINE GABEST AND TODAY I’M GOING TO DEMONSTRATE THE
ABDOMINAL EXAMINATION OF A PREGNANT PATIENT.

GOODMORNING MA’AM I’M MEDICAL STUDENT CHRISTINE, MAY I KNOW THE PATIENTS NAME AND BIRHTDAY? JUANA
DELA CRUZ, 27 YRS OLD. OKAY MA’AM SO TODAY I’M GOING TO BE THE ONE TO EXAMINE YOUR ABDOMEN WOULD
THAT BE OKAY? OKAY SO WHILE I WASH MY HAND AND PREPARE MY MATERIALS, I WOULD LIKE TO ASK IF YOU HAVE
EMPTIED YOUR BLADDER SINCE I’LL BE GOING TO PALPATE YOUR ABDOMEN AND IT MIGHT MAKE YOU A BIT
UNCOMFORTABLE. OKAY YOU’VE ALREADY PEED. THANKS MA’AM.

THIS IS THE HEAD OF THE PATIENT IN MY RIGHT SIDE

EXPOSE THE PATIENTS ABDOMEN.

INSPECT FOR LINEA NIGRA STRIAE, SHAPE SCARS. FETAL MOVEMENT

PATIENT HAS BROWN SKIN, AND PRESENCE OF LINEA NIGRA, STRIAE GRAVIDA. NO TO OTHER LESIONS OR SCARS
NOTED. ABDOMEN IS GLOBULAR IN SHAPE AND FUNDIC HEIGHT IS 38.

FOR LEOPOLD MANEUVER 1 GRASPS THE UTERINE FUNDUS WITH BOTH HANDS - IDENTIFY WHAT FETAL POLE
OCCUPIES THE FUNDUS. *FETAL HEAD- FIRM, HARD, ROUND, BALLOTABLE AND MOVABLE WHILE THE *BUTTOCKS IS
SOFTER AND BULKIER. FOR LM1 I’M FEELING A SOFT AND BULKY STRUCTURE. THE LM1 FINDING IS LM1 BREECH

FOR LEOPOLD’S MANEUVER 2 (UMBILICAL GRIP) GRASPS THE SIDES OF THE ABDOMEN WITH PALMS OF BOTH HANDS. -
DETERMINES ON WHICH SIDE IS THE FETAL BACK/ OR FETAL PARTS. IF IT’S THE FETAL PARTS YOU WILL FEEL AN
ANGULAR NODULATIONS SUGGESTING THAT IT’S THE FEATL ELBOWS AND KNEES WHILE A CONVEX , SMOOTH,
RESISTANT STRUCTURE SUGGESTS THAT IT’S THE FETAL BACK. FOR LM2 FINDING: FETAL BACK IS ON THE RIGHT.

LEOPOLD’S MANEUVER 3 (PAWLIK’S GRIP) -, GRASPS THE LOWER PORTION OF THE MATERNAL ABDOMEN JUST ABOVE
THE SYMPHYSIS PUBIS. - DETERMINES IF ENGAGEMENT OF THE FETAL PRESENTING PART HAS OCCURED. – LM3
CONFIRMS THE LM1 FINDINGS. FOR THE LM3 FINDINGS IT LM3 CEPHALIC.

LEOPOLD’S MANEUVER 4 (PELVIC GRIP) – I’LL REVRERSEMY POSITIONAND FACE THE LOWER PART OF THE MOTHER. -
PLACES ONE HAND EACH ON EITHER SIDE OF THE LOWER POLE OF THE UTERUS JUST ABOVE THE SYMPHYSIS PUBIS. -
DETERMINES ON WHICH SIDE IS THE CEPHALIC PROMINENCE AND CORRECTLY IDENTIFIES THE FETAL ATTITUDE. *IF
THE CEPHALIC PROMINENCE IS CLOSER TO THE FETAL BACK, THEN THE HEAD IS EXTENDED. IF IT IS CLOSER TO THE
FETAL PARTS, THE HEAD IS FLEXED. ALSO IF MY FINGERS DIVERGE UP TO THE PELVIC BRIM, THE FETUS IS SAID TO BE
ENGAGED. IF ITS STILL CONVERGES THEN THE FETUS IS UNENGAGED. FOR THE LM4 FINDING THE FETUS IS ENGAGED
AND HEAD IS EXTENDED.

I WILL NOW GET THE ESTIMATED FETAL WEIGHT. EARLIER THE FUNDIC HEIGHT IS 38 AND SINCE THE THE FETUS IS NOW
ENGAGED WE WILL SUBTRACT 12 FROM 38 AND MULTIPLY THE ANSWER TO A CONSTANT OF 155. THE ESTIMATED
FETAL WEIGHT IS 4030 GRAMS.

AUSCULTATE FOR THE FETAL HEART TONES, AND PLACE THE STETHOSCOPE AT THE FETAL BACK BASED ON THE
FINDINGS IN LM2. ASSUMING THAT I’VE ALREADY COUNTES FOR A FULL MINUTE, THE FETAL HEART RATE IS 140

WE DON’T NEED TO DO PERCUSSION SINCE THE PATIENT DIDN’T COMPLAIN ANY ABDOMINALDISCOMFORT.

COVER THE PATIENTS ABDOMEN AND DON’T FORGET TO THANK HER.

MA’AM WE’RE DONE, THANK YOU FOR YOUR COOPERATION. HAVE A NICE DAY PO. AFTER PATIENT INTERACTION DON’T
FORGET TO WASH HANDS. THAT’S ALL FOR TODAY DOC. THANK YOU PO