Care of the Growing Fetus

by Gina M. Dumawal RN,MAN

 Care of the Fetus

• Health history – nutritional intake, personal habits (cigarette

smoking, recreational drug use, and exercise), and any
accidents or experienced intimate partner abuse.
• Estimating fetal growth – McDonald’s rule
• Assessing fetal well-being
- fetal movement (quickening) minimum of 2x every 10 minutes
or an average of 10–12 times an hour.
- Fetal heart rate – 120 to 160 bpm (10th to 11th wk. with
doppler).
 Care of the Fetus
 Leopold’s Maneuver - systematic method of determining
the fetal presentation, position , attitude & fetal lie by
abdominal palpation.

 Consist of 4 distinct actions, each helping to determine the

position and presentation of the fetus.
1. First maneuver – fundal grip
2. Second maneuver – umbilical grip
3. Third maneuver – pawlik’s grip
4. Fourth maneuver – pelvic grip
 Care of the Fetus

 Fetal presentation
- the body parts that
will 1st contact the
pelvic inlet or to be
delivered first (cephalic ,
breech or shoulder).
 Care of the Fetus
 Fetal position
- relationship of the
presenting part to a
specific quadrant of
the woman’s pelvis
(maternal pelvis is
divided into four
quadrants, the left
and right anterior,
left & right posterior)
 Care of the Fetus
 Fetal position (cont.)
• Position is indicated by an abbreviation of three letters.
> middle letter denotes the
fetal landmark.
> first letter defines whether
the landmark is pointing to
the mother’s right (R) or
left (L).
> last letter defines whether
the landmark points
anteriorly (A), posteriorly (P),
or transversely (T).
 Care of the Fetus
 Fetal lie - the relationship between the long axis of the fetus
and the long axis of the woman’s body.(whether the fetus is
lying a horizontal/transverse lie or vertical/longitudinal lie).
 Care of the Fetus
 Fetal attitude - refers to the degree of flexion the fetus
assumes during labor.
 Development and Functions of Placenta
and Fetal Membranes
• Placenta - came from the Latin term for “pancake” for its
appearance. Nutrients, water as well as O2 are transported
through the placenta from the maternal blood supply to the fetus.
Development and Functions of Placenta
and Fetal Membranes
 Development and Functions of Placenta
and Fetal Membranes
• Umbilical Cord - contains only 1 vein, and 2 arteries
- connects the embryo to the chorionic villi of the placenta.
- transport of O2 and nutrients from the placenta to the fetus
and the return of waste products from the fetus to the placenta.
- made up of a gelatinous mucopolysaccharide called Wharton’s jelly
that protects the vein and arteries from trauma.
THANK
YOU !!!

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