Leopold’s Maneuvers

• 4 maneuvers described by Leopold in 1894

• Used to diagnose fetal presentation

• Can be used in late pregnancy and during labor between contractions 32 weeks

• Difficult if obese, polyhydramnios (madami panubigan) , or anterior placenta ( harap)

• Can estimate fetal size

• Poor correlation if obese

1. Uterine Fundus

• Used to determine fetal lie and which fetal pole (cephalic or podalic) occupies fundus

Palpate fundus

• Head: round, more mobile

• Breech: large, nodular mass

2. Fetal Orientation

• Used to determine position of fetal back

• Place palms on either side of maternal abdomen, exert gentle deep pressure

• Back: hard, resistant structure

• Directed anteriorly, posteriorly, transversely

• Fetal extremities: numerous small irregular mobile parts

3. Fetal Presentation

• Used to confirm fetal presentation (cephalic vs breech) and engagement

• The thumb and fingers of 1 hand grasp the lower portion of maternal abdomen above pubic symphysis

• Not engaged- movable mass is felt

4. Degree of Descent

• Used to determine the degree of descent

• Face pt’s feet, position fingertips of both hands on either side of the presenting part à exert inwards
pressure, slide caudad along the axis of pelvic inlet

• When the head has descended, can feet anterior shoulder or the space created by the neck from the
head
 Essential New Born Care

Drug Study

Oxytocin (Pitocin) – 10 units/ml cervical ripening , speed up labor , induced before labor of placenta
note to check /palpate for another fetal before injection.

Erythromycin - prevent certain eye infections : conjunctivitis and ophthalmia neonatorum

BCG – 0.05 ml : bacille Calmette-Guerin, is a vaccine for tuberculosis (TB) disease

Vit. K -0.5 ml leg IM- to form blood clots and to stop bleeding

Hepa B – 0.5 ml leg IM reduces the risk of your baby getting the disease from you or family members
who may not know they are infected with hepatitis B

Anthropometric measurements

1. Weight: 3.5 kg (7.5 lb), although between 2.5 kg (5.5 lb) and 4.5 kg (10 lb) is considered normal.
In general: Boys are usually a little heavier than girls. First babies are usually lighter than later
siblings. Note macrosomia (much larger than average for their gestational age : weigh over 8
pounds, 13 ounces.)

2. Head circumference: 34-35 cm above eye brow measured 3x

: note for – caput or cephalous , anencephaly ( small skull birth defect or
effect of micropil )

3. Chest circumference : 31-40cm above the nipple line note : panel , inverted

4. Abdomen circumference : 31-40 above umbilicus , note ; earnia (loslos)

5. Length – 50 cm : heel of the foot to buttock , to chest, to crown of the head

Fetal Heart Rate FHT

Fetal heart rate monitoring may help detect changes in the normal heart rate pattern during labor.

Baseline FHR variability: moderate. Late or variable decelrations: absent. Early decelerations: present or
absent

110 and 160 beats per minute. detectable between the 18th and 20th week.
VITAL SIGN

Check her vital signs

Blood pressure: normal values range between 90/60 mmHg to below 140/90 mmHg.

Maternal pulse rate: normal range is 80-100 beats/minute, but should not be greater than 110
beats/minute in a woman in labour.

Temperature: average 37oC; if it is between 37.5-38.4oC the woman has a low grade fever; if it is 38.5oC
or above, she has a high grade fever.

O2 – 85%

BABY BATH
PURPOSE

To be baby’s skin clean

To maintain healthy skin

To stimulate circulation

To refresh the baby

To detect any physical abnormalities

To monitor the infants growth and development

AFTER CARE

Dress the cord stump, if any

Dress the baby as early as possible

Comb the hair

Give the baby to the mother for feeding

Replace the articles after cleaning

Wash hands and record the procedure