Identify the correct obstetric grip?

AIIMS Delhi NO - 2017

Obstetrics & Gynaecology

Easy

Appeared in: AIIMS Delhi NO - 2017

Explanation

The image shows the examiner's hands placed on the lateral sides of the maternal abdomen, which is the correct technique for the Lateral Grip.
This maneuver is also known as the Umbilical Grip or the Second Leopold's Maneuver.
Its primary purpose is to determine the location of the fetal back versus the fetal small parts (limbs), which helps in assessing the fetal position within the uterus.
By identifying the smooth, hard surface of the back on one side and the irregular, knobby limbs on the other, the examiner can determine if the fetus is in a left or right position.

Option A: Pawlik's Grip (Third Maneuver) involves using only one hand to grasp the lower part of the uterus just above the pubic bone to feel the presenting part. The image clearly shows the use of two hands on the sides of the abdomen.
Option B: The First Pelvic Grip (Fourth Maneuver) requires the examiner to face the patient's feet and use the fingertips of both hands to palpate the lower abdomen to assess the fetal head's attitude and engagement. The image shows the examiner facing the patient's head and palpating the sides of the abdomen.
Option C: The Fundal Grip (First Maneuver) involves placing both hands on the top of the uterus (the fundus) to determine what fetal part (head or breech) is located there. The image shows hands on the sides of the abdomen, not the top.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of Leopold's Maneuvers (Obstetric Grips) as background academic context rather than a clinical decision trigger.
Leopold's maneuvers are a fundamental, non-invasive clinical skill for nurses and midwives to assess fetal lie, presentation, position, and engagement during antenatal check-ups and labor.
Accurate determination of the fetal back's location is essential for correctly placing the fetoscope or Doppler to auscultate the fetal heart rate.
Identifying an abnormal lie (like transverse) or presentation (like breech) through these maneuvers is critical for planning a safe delivery and making timely referrals if needed.

How to Approach the Question

First, carefully observe the image provided. Note the position of the examiner's hands on the pregnant abdomen.
Identify the specific action being performed. In this case, the hands are placed on the lateral (side) aspects of the uterus.
Recall the four Leopold's maneuvers and their respective names and techniques: Fundal Grip, Lateral Grip, Pawlik's Grip, and Pelvic Grip.
Match the observed action in the image with the correct maneuver. The hand placement corresponds to the Lateral Grip (Second Maneuver).
Review the given options and select the one that correctly names the maneuver shown.
Eliminate the other options by recalling their different hand placements and purposes (e.g., Fundal grip is at the top, Pawlik's is a one-handed grasp at the bottom).

Concept Tested & Keywords

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 16-24

E6 Obstetrics Williams p. 19-36