Pawliks manoeuvre is used to assess all of the following, except :

IGNOU PB Bsc Nsg.Entrance-2026

Obstetrics & Gynaecology

Easy

Appeared in: IGNOU PB Bsc Nsg.Entrance-2026

Explanation

Flexion of the fetal head, also known as fetal attitude, is not assessed by Pawlik's maneuver (the third Leopold maneuver).
Fetal attitude (flexion or extension) is determined during the fourth Leopold maneuver, or Pelvic Grip.
In the fourth maneuver, the examiner faces the mother's feet and palpates the lower pole of the uterus to locate the cephalic prominence, which indicates the degree of head flexion.

Option A: This is incorrect because a primary purpose of Pawlik's maneuver is to grasp the lower uterine segment to identify the presenting part (e.g., head or breech).
Option B: This is incorrect because by grasping the presenting part (usually the head) with the thumb and fingers, the examiner can make a general estimation of its size.
Option D: This is incorrect because Pawlik's maneuver directly assesses the mobility of the presenting part to determine if it is engaged (fixed) or unengaged (mobile) in the maternal pelvis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Leopold's Maneuvers and Antenatal Fetal Assessment 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 determine fetal lie, presentation, position, and engagement, which are crucial for planning the mode of delivery and anticipating potential labor complications.
Accurate assessment helps in identifying malpresentations like breech or transverse lie early, allowing for timely intervention such as counseling for an External Cephalic Version (ECV) or scheduling a cesarean section.
What if? - If the third maneuver (Pawlik's) reveals a soft, irregular, and non-ballotable mass, it would suggest a breech presentation. This finding would prompt the nurse to confirm with an ultrasound and prepare for discussions regarding delivery options, significantly altering the birth plan.

How to Approach the Question

First, identify the core subject of the question, which is 'Pawlik's manoeuvre'. Recall that this is another name for the third Leopold maneuver.
Next, recognize the keyword 'except'. This indicates that you must find the option that is NOT assessed by this maneuver.
Systematically review your knowledge of the four Leopold maneuvers and their specific purposes.
Recall that the first maneuver (Fundal Grip) checks the fundus, the second (Lateral Grip) finds the fetal back, the third (Pawlik's Grip) assesses the presenting part and its engagement, and the fourth (Pelvic Grip) assesses descent and attitude.
Based on this, evaluate the options: 'Presenting part', 'Size', and 'Mobility' are all related to grasping the lower pole of the uterus, which is the action of the third maneuver.
Identify that 'Flexion of fetal head' (attitude) is specifically assessed by the fourth maneuver, making it the correct exception.

Concept Tested & Keywords

QGHvEFWl_GKvsBDCMueH6z

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 pp. 19-36, 20-36