Professional Documents
Culture Documents
LM4: Pelvic Grip Determine whether head is
extended/flexed or whether
*only LM where the engagement has occurred
examiner faces the
mother’s feet LM4: Negative – fetal head is flexed,
this means engagement has not
occurred
• Fetal heart tone
o 6-8 weeks- could be detected by TVS
o 10-12 weeks- Doppler
o 18-20weeks- Stethoscope: Palpate the fetal back & place the bell of the
stethoscope over the FB and slightly place pressure on it
o Normal: 110-160bpm
• Breast examination
o Always perform!
o Respectfully ask the patient to remove clothing to expose both breasts
o Inspect à palpate outside going in à squeeze the nipples
o Normal: breasts are symmetric, skin colored, no dimpling, nipple not inverted,
no nipple retractions, no palpable masses & no nipple discharge
• Pelvic examination
o Inspect external genitalia for any local lesions that may be present or an
episiotomy scar
§ Normal: Pubic hair is coarse and thick, distributed in an inverted triangle
pattern. The labia majora is hyperpigmented and (not) coaptated. There
is a previous RMLE or ME wound. On palpation, there are no masses,
nor tenderness.
o Speculum examination
§ Describe the cervix and the vaginal discharge
§ Normal: Cervix is smooth, violaceous with minimal whitish non-foul
smelling discharge