Planning/Implementation:
First Maneuver:
With the examiner standing on the right side facing on the client, palpate side of the fundus with both palms, fingertips to determine which fetal pole is in the uterine fundus. For cephalic presentation: a hard, movable, regular mass is palpated whine a breach presentation, would be smooth, irregular, and slightly movable. With the fingers of the left hand, start from the umbilicus, count the number of finger breadths to the height of the fundus. This width approximate age of gestation (1 fingerbreadth to 1 month gestation)
Second Maneuver:
Place hands on the sides of abdomen downward to determine position of anterior shoulder, back and extremities.
Third Maneuver:
Grasp lower uterine segment between thumb and fingers of right hand to determine presentation and engagement.
Fourth Maneuver:
Examiner faces the foot part of the client. Palpate with both hands the sides of the fundus to confirm findings during the maneuver. Whether cephalic or breech presentation or how far engagement has occurred.
