Blog Search

Tuesday, April 24, 2012

Fetus in-utero

The lie 

Relationship between the long axis of the fetus and the long axis of the centralized uterus or maternal spine

long axis of the fetus is aligned to the mother’s
this is the only NORMAL position

long axis of the fetus is perpendicular to that of the mother’s

long axis of the fetus is 0-90 degrees (or 90-180 degrees) to that of the mother’s

The presentation

The part of the fetus which occupies the lower pole of the uterus

head down in the pelvis



head is up in the uterine fundus and the buttock in the pelvis



Relationship of fetal parts to each other:


Arbitrary bony fixed point on the presenting part




Deflexed (vertex)
Extended (vertex)


Frontal eminence

Flexed Vertex Presentation 8 Possibilities



Leopold’s Maneuver

Four-part process 
Determine the position of the baby  in utero 
Determine the expected presentation during labor and delivery 

Questions to ask yourself when performing the exam:
  • Is the fundal height consistent with the fetal maturity?
  • Is the lie longitudinal, transverse or oblique?
  • Is the presentation cephalic or breech? 
  • If cephalic, is the attitude vertex or facial? 
  • Is the vertex engaged?


Woman is supine, head slightly elevated and knees slightly flexed
If the doctor is R handed, stand at the woman’s R side facing her for the first 3 steps, then turn and face her feet for the last step (L handed, left side).

First Maneuver

What part is in the fundus?

Facing the mother, palpate the fundus with both hands
Assess for shape, size, consistency and mobility

Fetal head: firm, hard, and round
Detectable by ballotement

Buttocks/breech: softer and has bony prominences

Second Maneuver

Determine position of the back.

Still facing the mother, place both palms on the abdomen
Hold R hand still and with deep but gentle pressure, use L hand to feel for the firm, smooth back 
Repeat using opposite hands
Once you’ve located the back, confirm your findings by palpating the fetal extremities on the opposite side  (“lumpy”)

Third Maneuver

Determine what part is lying
above the inlet.

Gently grasp just above symphisis pubis with the thumb and fingers of the R hand 
Confirm presenting part (opposite of what’s in the fundus)
Head will feel firm
Buttocks will feel softer and irregular
If it’s not engaged, it may be gently pushed back and forth
Proceed to the 4th step if it’s not engaged…

Fourth Maneuver


Turn to face the woman’s feet
Move fingers of both hands gently down the sides of the abdomen towards the pubis 
Palpate for the cephalic prominence (vertex)
Prominence on the same side as the small parts suggests that the head is flexed (optimum)
Prominence on the same side as the back suggests that the head is extended

Using a Fetoscope

Fetal heart Rate (FHR) can be determined by use of:
specifically designed instruments 
Clinical stethescope
Electronic Doppler

Doppler Method

Employs a continuous ultrasound
Can detect the fetal heart at 10-12 weeks’ gestation

Amplifiers allow both the practitioner and parents to hear


Can pick up the fetal heart rate at 17-19 weeks’ gestation

Fetal heart tones are best heard over the baby’s back
Used in conjunction with Leopold’s maneuver
Auscultation may be difficult if
Mother is overweight
Placenta is in the front of the uterus

*Always easier in later stages of the pregnancy

Where will you hear the FHTs?

1 comment:

  1. Kronospoker situs penyedia Daftar Judi Poker Online Terpercaya, IDN Poker, capsa susun online, ceme online, ceme keliling, super10, omaha dan domino QQ terbaik dan terpercaya Indonesia. Kronospoker selalu memberikan pengalaman bermain judi kartu online terbaik kepada seluruh membernya.

    Disini kami telah mendapatkan kepercayaan dan reputasi terbaik dari para member Poker Indonesia, Karena kami memberikan pelayanan kepada semua member yang bermain di situs kami.

    Serta Berapapun kemenangan yang anda dapatkan akan langsung dibayar oleh Agen Judi Poker Online Terbaik Kronospoker, mau itu jackpot atau bonus lainnya.

    Semua permainan yang tersedia dapat anda mainkan hanya dengan menggunakan 1 user ID yang akan anda dapatkan setelah melakukan pendaftaran akun di Kronospoker. Selain menyediakan permainan Online Poker, Kronospoker juga menyediakan game Domino QQ, Capsa Susun terbaik di Indonesia.

    Pelayanan terbaik adalah prioritas utama dari Agen Judi IDN Poker Online Kronospoker. Kami menyediakan pelayanan customer service professional, sopan dan handal dalam bidangnya yang selalu siap membantu anda. Hanya dengan minimal deposit sebesar 10 ribu Rupiah, para pecinta permainan Judi Online dapat memainkan semua permainan yang tersedia di Kronospoker.

    Ada beberapa keunggulan yang membuat Agen Judi Poker Kronospoker menjadi Daftar Poker Indonesia Online Terpercaya. Dan menjadi salah satu tempat wajib bagi para pecinta permainan judi kartu online untuk bermain. Diantaranya yaitu:

    Dalam permainan judi online di Kronospoker, kami menjamin 100% player vs player. Dan itu berlaku untuk semua permainan yang ada. Semua murni tanpa adanya campur tangan robot ataupun admin kami.

    Kronospoker memberikan bonus Rollingan paling besar yang berlaku untuk semua jenis permainan.

    Proses transaksi yang cepat serta data para pemain dijamin keamanannya.

    Semua permainan dapat anda akses dengan mudah melalui komputer, notebook, dan smartphone Android maupun IOS.

    Situs judi online dengan winrate tertinggi. Win Rate dalam semua permainan di Kronospoker mencapai hampir 100%.


Follow by Email