SKILLS NECESSARY DURING ANTENATAL

CARE
• Leopold’s maneuver
• Auscultation of fetal heart tones

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 Abdominal examination during pregnancy

• Inspection
• Scars
• Shape and Size
• Palpation
• Checking the fundic height
• Estimation of fetal weight
• Leopold’s maneuver
2
How to measure the fundic height
Apply the tape with the calibration
hidden to avoid bias

Top of fundus
(do not push the
fundus down )

Upper edge
of symphysis
pubis

Bladder must be empty

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4
LEOPOLD’S MANEUVER:
Determine fetal orientation
First Maneuver: WHAT
OCCUPIES THE FUNDUS?
Face the woman’s head
with both hands, feel the
height of the fundus.
Which part of the fetus do
you feel?

5
2nd Maneuver:
• Feel the sides of
the uterus to find
the position of the
baby’s back and
extremities.
• Back feels
smooth
• Extremities feel
irregular
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3rd Maneuver: IDENTIFY
PRESENTING PART
• Grasp area
immediately above the
symphysis between
thumb and fingers
• HEAD: hard and
round, movable if
not engaged
• BREECH: feels softer
and irregular
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4th Maneuver
• Face the woman’s
feet. Place fingers on
both sides of the
lower abdomen and
press downwards and
inwards
• Determine fetal
occipital prominence
• Helps to identify the
presenting part and
whether it is engaged
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 Abdominal examination during pregnancy
• Inspection
• Palpation
• Auscultation of Fetal heart tones
• Easiest to hear over the baby’s back
• Normally 110-160 beats per minute
• If FHT cannot be heard after 6th month and no
fetal movement → REFER