An image shows a healthcare provider applying firm, downward pressure on the uterine fundus. What is the proc… - NORCET 9 Prelims-2025

NORCET 9 Prelims-2025

Obstetrics and Midwifery Nursing

Easy

Appeared in: NORCET 9 Prelims-2025

Explanation

The image clearly shows the application of manual pressure to the fundus (top part) of the uterus.
This procedure is correctly and descriptively termed 'Fundal pressure'.
It is also known by the eponym 'Kristeller maneuver', used to aid in the second stage of labor.
While its use is controversial due to associated risks, 'Fundal pressure' is the accurate name for the action depicted.

Option B: The McRoberts maneuver does not involve any pressure on the abdomen or uterus. It is a maternal positioning technique.
Option C: The Loveset maneuver is a procedure for delivering the arms of a baby in a breech presentation; it involves rotating the baby's trunk, not applying pressure to the mother's fundus.
Option D: This option is incorrect because a correct and specific answer, 'Fundal pressure', is available as Option A.

Visual 1: Diagram - A clear illustration of Fundal Pressure (Kristeller Maneuver) showing the direction of force on the uterus.
Visual 2: Diagram - An illustration of the McRoberts Maneuver, showing the hyperflexion of the maternal legs and the resulting change in pelvic angle.
Visual 3: Diagram - A step-by-step illustration of the Loveset Maneuver for a breech delivery.
Visual 4: Diagram - An illustration of Suprapubic Pressure, showing hand placement just above the pubic symphysis to dislodge an impacted shoulder.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of Obstetrical Maneuvers as background academic context rather than a clinical decision trigger.
It is critical for nurses to distinguish between fundal pressure and suprapubic pressure. Applying fundal pressure during shoulder dystocia is contraindicated and dangerous, as it can further impact the shoulder and lead to fetal injury (e.g., brachial plexus injury) or uterine rupture.
The primary nursing role during shoulder dystocia is to call for help, assist the mother into the McRoberts position, and apply suprapubic pressure as directed by the provider.
What if? If the scenario described a 'turtle neck sign' (fetal head retracting against the perineum after delivery), the correct immediate action would be to call for help and prepare for shoulder dystocia maneuvers like McRoberts, not to apply fundal pressure.

How to Approach the Question

First, carefully analyze the image provided. Identify the key action being performed: hands are pressing down on the top of the pregnant abdomen (the fundus).
Next, read the question, which asks to name the procedure.
Evaluate each option against your visual analysis.
Option A, 'Fundal pressure', is a direct and literal description of the action shown in the image.
Option B, 'McRoberts maneuver', involves moving the mother's legs, not pressing on her abdomen. This is incorrect.
Option C, 'Loveset Maneuver', is for breech deliveries and involves rotating the baby. This is incorrect.

Concept Tested & Keywords

Concept Tested: Identification of Obstetrical Maneuvers
Stem keywords: healthcare provider, downward pressure, uterine fundus, procedure
Lead-in keywords: What is the procedure
Clinical cues: Image shows hands pressing on the top of the uterus.

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