Identify the obstetric maneuver shown in the image.

NORCERT 8 Mains-2025

Obstetrics & Gynaecology

Easy

Appeared in: NORCERT 8 Mains-2025

Explanation

The image correctly depicts the Third Leopold's Maneuver, also known as Pawlik's Grip.
This maneuver is characterized by the use of a single hand, with the thumb and fingers spread, to grasp the lower uterine segment just above the symphysis pubis.
The primary purpose of Pawlik's grip is to identify the fetal presenting part (e.g., head or breech) and to determine if it is engaged (fixed) or unengaged (movable/ballotable) in the maternal pelvis.

Option A: The Fundal Grip is the First Leopold's Maneuver, which involves using both hands to palpate the top of the uterus (fundus), not one hand on the lower abdomen.
Option C: The Pelvic Grip is the Fourth Leopold's Maneuver. It requires the examiner to face the woman's feet and use both hands to palpate the presenting part as it enters the pelvis. The image shows a single hand with the examiner facing the woman's head.
Option D: The Lateral Grip is the Second Leopold's Maneuver. It uses both hands placed on the sides of the abdomen to locate the fetal back and limbs, which is different from the single-hand grasp shown.

Visual 1: Diagram - A comparative chart showing the hand placements for all four Leopold's maneuvers (Fundal, Lateral, Pawlik's, and Pelvic grips) on a pregnant abdomen. This helps learners differentiate them visually.
Visual 2: Infographic - A step-by-step guide on how to perform each of the four Leopold's maneuvers, with brief descriptions of the findings for each step.

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 as background academic context rather than a clinical decision trigger.
Leopold's maneuvers are a crucial, non-invasive clinical skill for nurses and midwives to assess fetal lie, presentation, position, and engagement during routine antenatal check-ups and labor.
The findings from these maneuvers help in anticipating the progress of labor and planning the mode of delivery, identifying potential complications like malpresentation (e.g., breech or transverse lie) that may require intervention.
What if? - If during Pawlik's grip, the presenting part is found to be soft, bulky, and irregular instead of hard and round, it suggests a breech presentation, which would significantly alter the management plan for labor and delivery.

How to Approach the Question

First, carefully analyze the image provided. Pay close attention to the number of hands being used and their specific placement on the pregnant abdomen.
Observe that the image shows a single hand grasping the lower part of the abdomen, just above the pubic area.
Recall the four distinct Leopold's maneuvers and the technique for each one.
Match the observed technique to the correct maneuver. The first (Fundal) and second (Lateral) maneuvers use two hands. The fourth (Pelvic) maneuver uses two hands with the examiner facing the patient's feet.
The third maneuver, Pawlik's Grip, is uniquely performed with one hand grasping the lower uterine segment.
Based on this systematic comparison, conclude that the maneuver shown is Pawlik's Grip.

Concept Tested & Keywords

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