Leopold's Manue

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LEOPOLD'S MANUEVER

In obstetrics, Leopold's maneuvers are a common and systematic way to determine the position of a fetus inside the woman's uterus; they are
named after the gynecologist Christian Gerhard Leopold. They are also used to estimate term fetal weight.

The maneuvers consist of four distinct actions, each helping to determine the position of the fetus. The maneuvers are important because they
help determine the position and lie of the fetus, which in conjunction with correct assessment of the shape of the maternal pelvis can indicate
whether the delivery is going to be complicated, or whether a caesarean section is necessary.

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 measured from the top of the mother's uterus to the top of the mother's pubic symphysis.
20 weeks at umbilicus.
36 week at the xyphoid process.
First maneuver: fundal grip Edit

While facing the woman, palpate the woman's upper abdomen with both hands. An obstetrician can often determine the size, consistency,
shape, and mobility of the form that is felt. The fetal head is hard, round, and moves independently of the trunk while the buttocks feel softer,
are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk.

Second maneuver: umbilical grip Edit

After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to
determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep
pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side
of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities
(arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the
upper abdomen and also a mass in the maternal inlet, lower abdomen.

Third maneuver: first pelvic grip or Pawlik's grip Edit

In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The
individual performing the maneuver first grasps the lower portion of the abdomen just above the pubic symphysis with the thumb and fingers of
the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor,
this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be
gently pushed back and forth.

The Pawlik's grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman.[citation needed]
Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part.[citation needed]
Fourth maneuver: Leopold's second pelvic grip Edit

The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers
of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers
toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal
back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back.

QUICKENING - Usually, quickening occurs naturally at about the middle of a pregnancy. A woman pregnant for the first time (i.e., a primigravida
woman) typically feels fetal movements at about 18–20 weeks, whereas a woman who has given birth at least once (i.e., a para woman) will
typically feel movements around 15–17 weeks.

What does gtpal stand for? GTPAL stands for Gravidity (number of pregnancies including current), Term (number of pregnancies carried to 37+
weeks), Preterm (number of pregnancies carried between 20 and 36.6 weeks ), Abortion (number of losses prior to 20 weeks), and Living
(number of living children).

Braxton Hicks contractions are sporadic contractions and relaxation of the uterine muscle. Sometimes, they are referred to as prodromal or
“false labor" pains. It is believed they start around 6 weeks gestation but usually are not felt until the second or third trimester of the pregnancy.

Chloasma Chloasma, also called melasma or the “mask of pregnancy,” is a common condition in pregnant women. In fact, it impacts the majority
of pregnancies, affecting up to 50% to 70% of expectant mothers. Is a common skin condition among pregnant women. It usually presents as
dark, brownish patches of skin, mostly on the forehead, nose, upper lip, and cheeks.

it is referred to as melasma. These changes in pigmentation are believed to be triggered by an increase in estrogen that stimulates the
production of melanin.

Linea nigra (Latin for "black line"), often referred to as a pregnancy line, is a linear hyperpigmentation that commonly appears on the
abdomen.The brownish streak is usually about a centimeter (0.4 in) in width. The line runs vertically along the midline of the abdomen from the
pubis to the umbilicus, but can also run from the pubis to the top of the abdomen.
For pregnant women, linea nigra is attributed to increased melanocyte-stimulating hormone made by the placenta,[3] which also causes
melasma and darkened nipples. Fair-skinned women show this phenomenon less often than women with darker pigmentation.[4] Linea nigra
typically disappears within a few months after delivery.

Pregnancy stretch marks, also known as striae gravidarum, are a specific form of scarring of the skin of the abdominal area due to rapid
expansion of the uterus as well as sudden weight gain during pregnancy. About 90% of women are affected.

The estimated date of delivery, also known as expected date of confinement, and estimated due date or simply due date, is a term describing
the estimated delivery date for a pregnant woman. Normal pregnancies last between 37 and 42 weeks.

The Naegele's formula is simple arithmetic method for calculating the EDD (estimated date of delivery) based on the LMP (last menstrual
period). To the date of the first day of the LMP (e.g. 22nd June 2008): add seven days (i.e 29th) subtract 3 months (i.e March)
Fetal lie refers to the relationship between the long axis of the fetus with respect to the long axis of the mother. The possibilities include a
longitudinal lie, a transverse lie, and, on occasion, an oblique lie. Fetal presentation is a reference to the part of the fetus that is overlying the
maternal pelvic inlet.
Fetal presentation is a reference to the part of the fetus that is overlying the maternal pelvic inlet. The most common relationship between
fetus and mother is the longitudinal lie, cephalic presentation. A breech fetus also is a longitudinal lie, with the fetal buttocks as the presenting
part.

Frank Breech has a chance of vaginal delivery as well as the Complete Breech.
Fetal position is the positioning of the body of a prenatal fetus as it develops. In this position, the back is curved, the head is bowed, and the
limbs are bent and drawn up to the torso. This position is used in the medical profession to minimize injury to the neck and chest.

. Occipiut
FETAL ATTITUDE. The fetal attitude describes the position of the parts of your baby's body. The normal fetal attitude is commonly called the
fetal position. The head is tucked down to the chest. The arms and legs are drawn in towards the center of the chest.

Description: the fetus assumes a good fetal attitude.


The most common early signs and symptoms of pregnancy might include:

 Missed period. If you're in your childbearing years and a week or more has passed without the start of an expected menstrual
cycle, you might be pregnant. ...
 Tender, swollen breasts. ...
 Nausea with or without vomiting. ...
 Increased urination. ...
 Fatigue.

The score has, Gravida (G)- indicating the present pregnancy, parity(P)- repesenting past pregnancies which have crossed the period
of viability of 28 weeks irrespective of the outcomes and abortion(A) is the third parameter considered.

Determining the Estimated Due Date

The estimated due date (EDD or EDC) is the date that spontaneous onset of labor is expected to occur. The due date may be estimated
by adding 280 days (9 months and 7 days) to the first day of the last menstrual period (LMP). This is the method used by "pregnancy
wheels".

Minus 3 on the month of LMP, plus 7 on the date of the first day of LMP and plus 1 on the year.
For the months of January, February and March, add 10 to the month of LMP, plus &7 on the date of the first day of LMP, and just
retain the year.

EX. LMP-10/9/2020
10 9 2020
-3 +7 + 1
7 16 2021

EDD 7/16/2021

NOTE: if the days in the addition of for the date of EDD is more than the days in the month, take the total and subtract it to the
number of days for that month.
EX. LMP – 1/28/2020
1 28 2020
+9 +7
10 35 2020

35
-31
4

THUS EDD IS 10/4/2020

NOTE: EDD is not 100% accurate birth 2 weeks before and after the EDD is still considered normal.

AGE OF GESTATION (AOG)


July 15, 2020 LMP
October 15, 2020 examination day

31 number of days in july


15 date of LMP
16

August – 31 days
September – 30 days
October – 15 date of examination
16 sum of the number of days in July and the date of examination day
92
Then divide 92 by 7 the number of days in a week

92/7 = 13.1

AOG – 13 1/7 WEEKS


ACTIVITIES OF THE HEALTH CENTER
WEDNESDAY NATIONAL IMMUNIZATION DAY
PRENATAL TUESDAY AND THURSDAY
MONDAY CONSULTATION DAY

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