Lecture on Leopold Maneuvers and Fetal Heart Rate Monitoring

Introduction

Presenter: Meris
Topics: Leopold maneuvers and fetal heart rate (FHR) monitoring during labor and delivery.
Resources: Maternity flashcards from LevelUpRN.com

Purpose: Non-invasive technique to assess fetal position and presentation.
Steps of Leopold Maneuvers:
1. Palpate the Fundus:
  - Determine if feet (head down) or head (head up) is at the top of the uterus.
  - Use the mnemonic "start from the top."
2. Feel Along Sides of Uterus:
  - Locate the baby's back (smooth) vs. limbs (jagged, pointy).
3. Palpate Above the Pubic Bone:
  - Check if the part is engaged in the pelvis.
  - If not movable, it's fully engaged.
4. Assess Fetal Attitude (Cephalic Presentation):
  - Use fingers to determine head position (flexed or extended).
  - Ideal position: head tucked in.
Illustrations:
- Visual aids are available in the flashcards for better understanding.

Methods:
- External Monitoring:
  - Equipment: Straps across the belly with two transducers.
  - Tocometer: Measures strength of contractions at the fundus.
  - Fetal Heart Rate Transducer: Requires ultrasound jelly; assesses fetus's heart rate.
  - Placement: Varies with fetal position (breech or cephalic/vertex).
  - Listening Position: Along the fetal back for an accurate reading.
- Internal Monitoring:
  - Equipment: Internal fetal heart rate monitor with a small electrode.
  - Placement: On the presenting part of the fetus, usually the head.
  - Risks: Concerns about infection, especially with conditions like HIV/AIDS.
  - Requirements: Membranes must be ruptured for placement.

Internal Monitoring Risks:
- Increased risk of infection.
- Not recommended for patients at risk or with HIV/AIDS.
- Requires ruptured membranes.

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