fetus in utero

1. By ,
Mrs.Vaibhavi Panchal
Lecturer,M.sc Nursing(OBGY)
Dr.Hedgewar College of Nursing
Aurangabad.

2.  The lie is refers to the relationship of the long axis of the
fetus to the long axis of the centralized uterus.
There are mainly three types of lie.
 Longitudinal lie:
long axis of the fetus is aligned to the mother’s
This is the only normal lie of the fetus.
 Transverse:
long axis of the fetus is perpendicular to that of the
mother’s.
 Oblique:
Long axis of the fetus is 0-90 degrees (or 90-180 degrees)
to that of the mother’s

4. The presentation is the part of the fetus
which occupies the lower pole of the
uterus is called presentation of the fetus.
The presentation either ,
1. vertex or cephalic (96. 5%)
2. breech (3%)
3. shoulder (0.5%)

7.  the presenting part is defined as the part of
the presentation which overlies the internal os
and is felt by the examining the finger through
the cervical opening.
1. In cephalic presentantion , the presenting
part is vertex
2. In face presentation , presenting part is brow
or face.
3. In breech presentation , the presenting part
is legs or buttocks.

8. The relation of the different parts of the
fetus to one another is called attitude of
the fetus.
There three types of attitude in fetus,
1. Flexed
2. Deflexed
3. Extension

10. It is an arbitrary bony fixed point on the
presenting part which comes in relation
with the various quadrant of the maternal
pelvis.
1. Occiput in vertex
2. Mentum in face
3. Frontal in brow
4. Sacrum in breech
5. Acromion in shoulder.

11. It is the relation of the denominator to the
different quadrants of the pelvis.
There are 8 positions of presenting part.
1. In vertex presentation:
LOA
LOT
LOP

12. 2. In face presentation
LMA
LMT
LMP
3. In breech presentation
LSA
LST
LSP

15. it is the relation of the presenting part to
the ischial spine. If the presenting part is at
the level of ischial spine.
 station 0 is at the ischial spine

17. Inspection:
(1) whether the uterine ovoid is longitudinal or
transverse or oblique
(2) Contour of the uterus—fundal notching,
convex or flattened anterior wall, cylindrical or
spherical shape
(3) Undue enlargement of the uterus
(4) skin condition of abdomen for evidence of
ringworm or scabies and
(5) any incisional scar mark on the abdomen.

18. Palpation
Height of fundus

20. 1. Fundal grip (first Leopold) :-
The palpation is done facing the patient’s
face . the whole of the fundal area is
palpated using both hands laid flat on it to
find out which pole of the fetus is lying in
the fundus.

21. (a) Broad, soft, and irregular mass
suggestive of breech
(b) smooth, hard and globular mass
suggestive of head
In transverse lie neither fetal poles are
palpated in the fundal area.

23. 2. Lateral or umbilical grip( second Leopold):
 The palpation is done facing the patient’s
face.
 determine the position of the fetal back and
small parts)
 Hands are placed on each side of the
umbilicus. The back will palpate as firm, flat
and linear. The fetal extremities are palpable
by their varying contour and movements. The
purpose of this maneuver is to determine
whether the fetal back is left or right.

25. 3. Pawlik’s grip (third Leopold):-
 The examination is done facing towards
the patient’s face.
The over strectched thumb and four
fingers of the right hand are placed over
the lower pole of the uterus keeping the
ulnar border of the palm on the upper
border of the symphasis pubis

26. When the fingers and thumb are
approximated, the presenting part is
grasped distinctly ,if not engaged and also
the mobility from side to side is tested.
In transverse lie, pawlik grip is empty.

28. 4. Pelvic grip (fourt Leopold) :
The examination is done facing the
patient’s feet.
Four fingers of both the hands are placed
on either side of the midline in the lower
pole of the uterus and parallel to the
iguinal ligament

29.  The fingers are pressed downwords and
backwards in a manner of approximation of
finger tips to palpate the part occupying the
lower pole of the uterus (presentation).
 To ascertain the presenting part ,
• Head will feel firm
• Buttocks will feel softer and irregular

30. The engagement is ascertained nothing
the presence or absence of the sincipital
and occipital poles whether there is a
convergenece or divergence of fingertips
during palpation.
(A) Divergence of fingers— engaged head
(B) Convergence fingers— not engaged
This pelvic grip using both the hands is
favoured as it is most comfortable for the
woman and gives most information