Abdominal Exam

Question 1

What are we assessing in an abdominal exam?

Answer 1

Fetal growth, size and wellbeing

Question 2

What are we inspecting for?

Answer 2

Fetal movements
Skin
Size
Shape

Question 3

What do we assess when palpating?

Answer 3

Fundal height
Lie
Attitude
Position
Presentation
Engagement

Question 4

When would we do an abdominal exam?

Answer 4

Antenatal clinic 
Antenatal ward admission
Prior to invasive screening 
Prior to auscultation or CTG
Prior to VE 
In labour

Question 5

Name the 3 types of palpation

Answer 5

Fundal palpation
Lateral palpation
Pelvic palpation

Question 6

Explain fundal palpation

Answer 6

Place hands below xiphisternum, move down until the firmness of the fundus is felt, use the palm to palpate and identify the pole
Once fundus identified, measure using a non elastic tape measure cms down from top of fundus to symphysis pubis. Measure once, repeat every 2-3 weeks and refer if necessary as per NMC Code

Question 7

Explain lateral palpation

Answer 7

One hand supports the uterus at umbilicus level other palpates and progresses length
Assess for:
Lie 
Attitude 
Denominator 
Position

Question 8

Explain pelvic palpation

Answer 8

Use both hands, fingers facing feet and press down gently to assess presentation and engagement
Presentation - part of the baby first to deliver, cephalic (head), breech (bottom), face, brow, shoulder
Engagement- relationship of presenting part and pelvic brim

Question 9

Explain auscultation

Answer 9

Palpating to located the position and presentation identifies when to place the equipment as the clearest sounds are heard through the scapula.
We assess for presence, rate (110-160), regularity & variability
Use of pinard or sonicaid

Question 10

How would we document abdominal examination

Answer 10

Document as per the NMC Code 
Systematic 
Consent 
Visual inspection 
Fundal height
Lie
Attitude 
Presentation 
Position 
Engagement 
Auscultation
Refer if abnormal as per NMC Code