AM+DG

Purpose Procedure Findings

First Maneuver: To determine fetal part 1. Stand at the foot of the client, Head
Fundal Grip lying in the fundus facing her  More firm, hard, and
2. Place both hands on her round that moves
abdomen, keep hands on a flat independently of the
position body
To determine 3. Palpate the superior surface of Breech
presentation the fundus  Less well-defined that
4. Determine consistency, shape, moves only in conjuction
and mobility of the part with the body
palpated

Second Maneuver: To identify location of 1. Facing the client, place one hand Fetal Back
Umbilical Grip the fetal back steady to the uterus on one side of  Smooth, hard, resistant
the abdomen surface
2. While the other hand moves
Knees and elbows
slightly on a circular motion from
To determine position  Feel with a number of
top to the lower segment of the
uterus to feel for the fetal back and angular nodulation
small fetal parts
3. Use gentle but deep pressure
4. Repeat the same palpation on the
opposite side

Third Maneuver: To determine 1. Still facing the client and using  Presenting part is
Pawlik’s Grip engagement of thumb and finger, grasp the ENGAGED if it is NOT
presenting part lower portion of the abdomen MOVABLE
above symphysis pubis
2. Press in slightly and make  It is NOT YET ENGAGED
gentle movements from side if it is still MOVABLE
to side
3. Determine whether the part is  Establishes whether the
mobbing and whether it is soft part is cephalic or breech
or firm

Fourth Maneuver:
Pelvic Grip (done only if the
presenting part is Cephalic)
To determine the 1. Facing foot part of the Good Attitude
degree of flexion of woman, place fingers on both  If brow correspond to
fetal head sides of the uterus approx. 2 the side of the (2nd
inches above the inguinal area maneuver) that
To determine attitude or the Poupart’s ligament contained the elbows
or habitus 2. Pressing downwards and and knees
inwards in the direction of the Poor Attitude
birth canal  If examining fingers will
3. Allow fingers to be carried meet an obstruction on
downwards the same side as fetal
4. Use both hands back (hyperextended
head)
 Also, palpates infant’s
anteroposterior position
 If brow is very easily
palpated, fetus is at
posterior position
(occiput pointing
towards the woman’s
back)

Preparation
1. Instruct woman to empty her bladder first
2. Place woman in dorsal recumbent position, supine with flexed knees to relax abdominal muscles. Place a small
pillow under the head for comfort
RDJ || @ralph_adj
 AM+DG
3. Drape properly to maintain privacy
4. Explain procedure to the patient
5. Warm hands by rubbing together. (Cold hands can stimulate uterine contractions)
6. Use palm for palpation not the fingers

RDJ || @ralph_adj