AIIMS Delhi NO- 2019
Obstetrics & Gynaecology
Easy
Which Leopold maneuver is used to assess the fetal attitude during abdominal palpation of an ANC mother?
Appeared in: AIIMS Delhi NO- 2019
Explanation
- The fourth Leopold maneuver, also known as the Pelvic Grip, is the specific technique used to assess fetal attitude.
- Fetal attitude describes the relationship of the fetal head to its body, specifically its degree of flexion or extension.
- During this maneuver, the examiner faces the mother's feet and palpates the fetal head as it enters the pelvis.
- By locating the cephalic prominence, the examiner can determine if the head is flexed (normal) or extended (abnormal).
- If the prominence is on the same side as the fetal back, the head is extended; if it's on the side of the small parts, the head is flexed.
Why Other Options Were Wrong
- Option A: The first maneuver (Fundal Grip) is used to determine what fetal part (head or breech) is in the uterine fundus, which helps identify the fetal lie and presentation, not the attitude.
- Option B: The second maneuver (Lateral/Umbilical Grip) is used to locate the fetal back versus the small parts (limbs), which determines the fetal position (e.g., left or right occiput anterior), not the attitude.
- Option C: The third maneuver (Pawlik's Grip) is used to confirm the presenting part over the pelvic inlet and to determine if it is engaged (fixed) or unengaged (movable). It does not assess the degree of head flexion.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment of Fetal Attitude using Leopold's Maneuvers as background academic context rather than a clinical decision trigger.
- Leopold's maneuvers are a fundamental, non-invasive nursing skill used to determine the fetus's position in utero, which is crucial for planning and managing labor and delivery.
- Identifying an abnormal attitude, such as an extended head (face or brow presentation), can alert the clinical team to a higher risk of cephalopelvic disproportion, prolonged labor, or the need for operative delivery.
- The findings from these maneuvers help the nurse anticipate the labor pattern, locate the fetal heart for monitoring, and prepare for potential delivery complications.
How to Approach the Question
- This is a factual recall question that tests your knowledge of a standard obstetric assessment procedure.
- First, identify the key concept in the question stem: 'fetal attitude'.
- Recall the definition of fetal attitude, which is the relationship of the fetal parts to one another, specifically the degree of flexion or extension of the head.
- Systematically review the purpose of each of the four Leopold maneuvers.
- The First Maneuver (Fundal Grip) assesses lie and presentation.
- The Second Maneuver (Lateral Grip) assesses position.
Concept Tested & Keywords
- Concept Tested: Assessment of Fetal Attitude using Leopold's Maneuvers
- Stem keywords: Leopold maneuver, fetal attitude, abdominal palpation, ANC mother
- Lead-in keywords: Which
Question ID
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Reference Book
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 16-24
E6 Obstetrics Williams p. 19-36
E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 200-202
Practise the full AIIMS Delhi NO- 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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