Fundal height, or McDonald's rule, is a measure of the
size of the uterus used to assess fetal growth and
development during pregnancy. It is typically done to
determine if a baby is small for its gestational age. It is
measured from the top of the mother's uterus the
fundus to the top of the mother's symphysis pubis.
The measurement is generally defined as the distance
in centimetres.
The pregnant woman is 32 wks pregnant her fundal
height must be 32cm or close to 32 which is 30 or 34.
Normal measure of fundal height should be the same
of the weeks of pregnancy or minus plus two cm.
Before the procedure you must ask the pt if she
already voided before going here. If not let her void
first to have an accurate measurement of fundal
height. The head must be slightly elevated and put a
towel underneath to prevent the pt having supine
hypotension.
Hello maam, My name is Ashley your nurse for today,
so It is okay to expose your abdomen?, because I’m
going to start the procedure, So the pt is 32 wks and
the measurement of her abdomen is 30cm which is
normal.
Leopold's maneuvers are four specific steps in
palpating the uterus through the abdomen in order to
determine the lie, presentation, position and
engagement of the fetus.
FETAL LIE
Is the relationship between the long axis of the
fetal body and the maternal long axis.
Transverse of Longitudinal
Longitudinal lies are further classified into
CEPHALIC OR BREECH.
FETAL POSITION
• Is the relationship of the presenting part to a
specific quadrant and side of a woman’s pelvis.
ENGAGEMENT
• Refers to the setting of the presenting part of the
fetus far enough into the pelvis that it rests at the level
of the ischial spine.
Fundal Grip to determine the Presentation
Umbilical Grip to determine the back and lie
Pawlick’s grip to determine the engagement
Pelvic Grip to determine the fetal attitude
1st Maneuver is FUNDAL GRIP is to determine
presenting part at the fundus. While facing the
woman, palpate the woman’s abdomen w/ both
hands. It is often done to determine the size,
consistency, shape, & mobility of the form that is feet.
If I will palpate is the fetal head it is called breech,
hard, firm, round, and moves independently of the
trunk.
If buttocks it is cephalic softer, symmetric, small bony
prominences and It moves with the trunk
2nd Maneuver is UMBILICAL GRIP to determine the
location of fetal back. Facing the woman palpate each
side of the abdomen with gentle but deep pressure
using tips of hands. If fetal back is firm, smooth and
hard resistant and If fetal extremities feels like small
irregularities and protusions.
3RD Maneuver is PAWLICK’S GRIP to determine what
fetal part is lying above the inlet, or lower abdomen
just above the symphisis pubis with thumb and fingers
of the right hand. If not engaged there is no space or
its floating and if it is engaged there is no space.
4th Maneuver is PELVIC GRIP to determine the degree
of flexion of fetal head. Facing to the woman’s feet
and attempt to locate the fetus brow or forehead.
Both hands fingers are moved gently down the sides
of the uterus towards the pubis. To determine if its
good attitude the brow corresponds to the side that
contained the elbows & knees are flex and bowed the
chin must be stick to the chest. Poor attitude when
examining the fingers will meet an obstruction on the
same side as fetal back and it extends.
Anthropometric data is used for the study of human
body measurement for anthropological classification
and comparison. Anthropometric measurements are
used to assess the size, shape and composition of the
human body. It helps us to determine if the
measurement of a newborn is in normal range, and to
early determine if there’s any problems or condition
to a newborn.
Make sure that the newborn is comfortable in a warm
room, and a proper light to have an accurate
procedure.
I’m going to measure first the head circumference, 2 nd
chest circumference, 3rd abdominal circumference, 4th
weight, and last the height/length of the baby.
The newborn female baby named Viy she is two
weeks old. I’m going to use tape measure in
centimetre and baby weighing scale.
The normal range of every measurements are:
Weight- 2500-3500 grams
Head circumference- 33-35 cm
Chest circumference- 31-33cm
Length- 45-55cm
Abdomen- 29-31 cm
Baby’s measurement
Head is 33cm, Abdomen is 30cm, Chest is 32cm,
Weight is 3000 grams, and length is 49cm.
