Wednesday , September 19 2018
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Uterine Palpation Assessment

Assessing Uterine Contraction by Palpation

Purpose

  • To determine whether a contraction pattern typical of true labor.
  • To identify abnormal contraction that may jeopardize the health of the mother or fetus.
  • To prevent health hazards which mother be exposed.
  • To detect, diagnose and provide proper management of any hazards as early as possible.

Scope

All pregnant women

Definition

A method of examination in which a rhythmic tightening in labor of the upper uterine musculature that contracts the size of the uterus and pushes the fetus towards the birth canal.

Applicable Areas

Gyneac & Obstetric Department and Gyneac & Obstetric OPD.

Responsibility

Consultant, Medical Officer, Staff Nurse, Auxillary Nurse Midwife and Head Nurse.

Equipment

  • Stop Watch
  • Screen

Procedure

  • Wash hands.
  • Explain procedure and its purpose.
  • Prepare equipment and take to bedside.
  • Put the mother in dorsal recumbent position and screen the mother bed.
  • Close windows if open.
  • Assess at least three contractions in row but preferably more.
  • Assess more frequently, if abnormalities.
  • Place fingertips of one hand on uterine fundus. Keep fingertips relative them over uterus.
  • Note time when each contraction begins and ends.
  • Determine frequency by calculating average time that elapses from beginning of one contraction until beginning of next one.
  • Determine duration by noting average time in seconds from beginning to end of each contraction.
  • Determine interval by noting average time between end of one contraction and beginning of the next one.
  • Estimate the average intensity of contractions by noting how easily the uterus can be indented during the peak of the contraction as follows :
  • Mild contractions are easily indented with fingertips. They feel similar to the tip of the nose.
  • Moderate contractions can be indented with more difficulty. They feel similar to chin.
  • Firm contractions are feel woody and cannot be ready indented. The feel similar to the forehead.
  • The average frequency (in minutes & fraction), duration (in seconds) and intensity.

Hypertonic contraction

  • Duration longer than 90 seconds.
  • Interval shorter than 60 seconds.
  • Incomplete relaxation between contractions.
  • Remove equipment and wash hands.

Documentation

Nurse’s Observation Sheet.