A nurse performs four pelvic grips on an antenatal woman in her third trimester to determine the \ \ \ \ \ \ - BTSC Staff Nurse 1 August-2025

BTSC Staff Nurse 1 August-2025

Obstetrics & Gynaecology

Easy

Appeared in: BTSC Staff Nurse 1 August-2025

Explanation

The four pelvic grips are collectively known as Leopold's maneuvers, a standard procedure in late pregnancy.
Their primary purpose is to systematically determine the fetal lie (the orientation of the fetal spine relative to the mother's spine) and presentation (the fetal part entering the pelvis first).
This information is critical for anticipating the labor process and planning for a safe delivery, including identifying non-cephalic presentations like breech or transverse lie.
The maneuvers involve four distinct steps: Fundal Grip, Lateral Grip, Pawlik's Grip, and Pelvic Grip, each providing specific information about the fetus's position.

Option B: Fetal heart rate is auscultated with a fetoscope or Doppler, not determined by palpation. While fetal movements can be felt, assessing their pattern or viability is not the primary goal of these specific grips.
Option C: Fundal height is a specific measurement taken with a tape measure from the pubic symphysis to the uterine fundus to assess fetal growth and estimate gestational age. While the first Leopold's maneuver identifies the fundus, the overall purpose of the four grips is much broader than just measuring height.
Option D: Gestational age is estimated based on the last menstrual period (LMP), early ultrasound measurements, and fundal height. The pelvic grips themselves do not provide a direct measurement or determination of gestational age.

Clinical Relevance

Nursing practice connection: Use the key finding related to The concept tested is the purpose of performing Leopold's maneuvers (four pelvic grips) during an antenatal examination to guide bedside assessment, documentation, and the next nursing action.
Leopold's maneuvers are a fundamental, non-invasive, and cost-effective clinical skill for nurses and midwives to assess fetal position before and during labor.
Early identification of a malpresentation, such as a breech or transverse lie, is critical for safe delivery planning. It allows for counseling the patient, scheduling an external cephalic version (ECV), or planning for a cesarean section.
What if? If the second maneuver identifies the fetal back on the mother's right side and small parts on the left, and the third maneuver identifies the head in the pelvis, the position is likely Right Occiput Anterior (ROA) or Right Occiput Transverse (ROT). This information helps the nurse anticipate the labor pattern and where to best place the monitor for fetal heart sounds.

How to Approach the Question

First, identify the clinical procedure described in the question stem: 'four pelvic grips on an antenatal woman in her third trimester'.
Recall the medical term for this procedure, which is Leopold's maneuvers.
Access your knowledge about the primary purpose of Leopold's maneuvers. What key information do they provide about the fetus?
Evaluate the given options to see which one accurately describes this primary purpose.
Option A, 'fetal lie and presentation,' directly corresponds to the goal of determining the baby's position and orientation in the uterus.
Eliminate the other options by considering how they are typically assessed: FHR with a Doppler, fundal height with a tape measure, and gestational age via LMP/ultrasound/fundal height.

Concept Tested & Keywords

Concept Tested: The concept tested is the purpose of performing Leopold's maneuvers (four pelvic grips) during an antenatal examination.
Stem keywords: four pelvic grips, antenatal woman, third trimester
Lead-in keywords: determine

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E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 200-202

E6 Obstetrics Williams p. 19-36