must be 24 weeks gestation.
Instruct woman to empty her bladder first
Place woman in dorsal recumbent position, supine with knees flexed to relax abdominal muscles
Place a small pillow under the head for comfort.
Drape properly to maintain privacy.
Explain procedure to the patient.
Warms hands by rubbing together. (Cold hands can stimulate uterine contractions).
Use the palm for palpation not the fingers.
fundal grip - purpose?
- determine presentation, what part of the fetus is in the fundus
- both hands
- feel for the part of the fetus that is in the fundus
- head: firm, round, moves independently from the trunk
- breech: less defined, moves with the trunk
umbilical grip:pu rpose?
- determine position, where is the fetal back
- one hand on each side
- feel for the back and small fetal parts
- move in circular motions from top to bottom
- fetal back: smooth, hard, resistant surface
- fetal knees and elbows: several angles
- to determine the presenting part
- use thumb and forefinger
- grasp above the symphisis pubis
- press slightly, move from side to side
- moveable: not engaged
- not moveable: engaged
determine the attitude of the fetus
- face foot of bed
- use both hands
- palpate head, pressing down
chin towards chest or looking up