# Examination of the Pregnant Abdomen

## Overview

This module describes how to examine the pregnant abdomen using the Leopold Manoeuvres.

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“I am going to examine your tummy to determine the position of your baby.”

### What can my patient expect?

“I am going to look at and feel your tummy from top to bottom. I will listen to your baby’s heart with a special stethoscope.”

### What is my patient’s role?

“Try to stay relaxed. Let me know if anything is painful, and let me know if you feel faint during the examination. It will be more comfortable for you with an empty bladder. I can then also test your urine. ”

## Preparation

Ensure a female chaperone is present. Perform urinalysis if a midstream urine sample was collected.

### Documentation

### Equipment

## Site & Positioning

The patient should be positioned supine, with a pillow under the right hip to avoid

aortocaval compression syndrome

aortocaval compression syndrome

This occurs due to pressure on the aorta and inferior vena cava by the fetus. The patient may develop hypotension or even become unconscious.

.

## Procedure

Follow medical asepsis without gloves.

## Troubleshooting

The symphysis-fundal height measures more than the calculated gestational age

The patient needs an ultrasound assessment to confirm gestational age if less than 24 weeks, rule out multiple pregnancy and measure amniotic fluid index.

The symphysis-fundal height measures less than the calculated gestational age

The patient needs an ultrasound assessment to confirm the gestational age if less than 24 weeks, rule out intrauterine growth restriction and measure amniotic fluid index.

I feel uterine contractions when I palpate the abdomen.

This is likely due to uterine irritability, normal from 36 weeks. If the uterus is irritable before 36 weeks, it suggests intrauterine growth restriction.

The head feels too small for the size of the uterus.

This suggests multiple pregnancy. This patient needs an ultrasound assessment.

The head feels too hard for such a small head.

This suggests intrauterine growth restriction. This patient needs an ultrasound assessment.

It is very difficult to palpate anything.

This is common in obese patients, and in patients with polyhydramnios. This patient needs an ultrasound assessment.

## Risks

## References