Before placing the fetal monitoring device on a primigravid client’s fundus, the nurse performs Leopold’s maneuvers. When performing the third maneuver, the nurse explains that this maneuver is done for which of the following reasons?
To determine whether the fetal presenting part is engaged.
To locate the fetal cephalic prominence.
To distinguish between a breech and a cephalic presentation.
To locate the position of the fetal arms and legs.
The correct answer and explanation is :
The correct answer is To distinguish between a breech and a cephalic presentation.
Leopold’s maneuvers are a series of four palpations used by healthcare professionals to assess the position of the fetus within the uterus during pregnancy. These maneuvers provide valuable information about fetal positioning, the location of the fetal parts, and the presentation of the fetus. The third maneuver, in particular, is specifically used to help determine whether the fetus is in a breech or cephalic presentation.
Explanation of Leopold’s Maneuvers:
- First Maneuver: The nurse palpates the upper part of the abdomen to determine which part of the fetus (head or buttocks) is located in the fundus. This helps identify whether the fetus is in a cephalic (head-down) or breech (buttocks or feet down) position.
- Second Maneuver: This maneuver involves palpating the sides of the abdomen to determine whether the fetus’s back is on the left or right side. The back feels firm and smooth, whereas the limbs are more mobile and can feel knobby or irregular. This helps assess the orientation of the fetus.
- Third Maneuver: The third maneuver involves palpating the lower abdomen to determine the presentation of the fetus. In this step, the nurse seeks to distinguish between a breech presentation (where the buttocks or feet are presenting) and a cephalic presentation (where the head is presenting). By palpating the lower part of the abdomen, the nurse can feel for the fetal head or buttocks. A hard, round mass indicates the fetal head, whereas a softer, irregular mass suggests the buttocks. This helps in determining the fetal presentation and whether the birth will be a head-first (cephalic) or buttocks-first (breech) delivery.
- Fourth Maneuver: This maneuver is used to determine the descent of the fetal head into the pelvic inlet and to assess the engagement of the presenting part.
Overall, the third Leopold’s maneuver is crucial in helping the nurse distinguish between a breech and a cephalic presentation, which is important for determining the method of delivery and for planning appropriate interventions during labor and birth.