FUNDUS MASSAGE SBPANGILINAN

2023 ward UTERINE FUNDUS MASSAGE

I. Definition
- a technique used to help the uterus shrink and expel blood clots after labor; it
involves rubbing the mother's fundus (the top of the uterus) vigorously. 
II. Goal
- to help expel blood clots and prevent postpartum hemorrhaging.
III.Rationale
- to help encourage the uterus continue to contract and prevent postpartum
hemorrhage.
 After the placenta detaches and is delivered, the area where it was
attached to the uterine wall bleeds.
 Uterine contractions naturally help to push out this blood and put
pressure on the blood vessels in the uterus in order to stop the
bleeding.
 For this reason, fundal massages are performed whether a vaginal
or C-section delivery.

IV. Nursing management

 Wash hands, wear gloves
 Identify the patient
 Greet by name, check the wrist band (name, date of birth)
 Provide privacy – close the curtains/ or cover the abdomen with blanket
 Explain the procedure
 Assess: abdominal cramping
 Check the uterine fundus
 find the fundus located right around, or right below the umbilicus post-partum. 
 Hand position: above the symphysis pubis (capped)& at the umbilicus

 Note: encourage patient to void before palpation of the uterine fundus because a
full bladder displaces the uterus and can lead to excessive bleeding.

 Re-measure the fundal level (using finger- breath)

 Boggy (soft) – check for hemorrhage (inspect perineal pads for flow - amount,
color, odor; episiotomy)
 Firm – active uterine contraction
 “massage” the uterus gently in circular motion
 *Uterine muscle contracts to its firmness
 continue massaging the uterus with one hand, support the bottom of the uterus
near the pubic bone with the other hand.
 In some cases, perform a fundal massage with a hand in the vagina in order to compress
the uterine arteries (bimanual compression”)

 given until the uterus feels firm; the amount of time varies, but they can be given
as often as every 10mins
 feel the stomach and uterus routinely.

 Note: After delivery the uterus should feel hard like a softball, and be at or just below the
umbilicus
 If the uterus isn’t firm, it typically hardens up after fundal massage once blood or clots
are expelled.

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FUNDUS MASSAGE SBPANGILINAN

how does fundal massage feel 

 definitely isn’t relaxing; varies in intensity for everyone
 particularly due to the amount of pressure needed to impact the
uterus.
 The resulting uterine contractions, often known as after pains, can also be a bit
uncomfortable…though after labor, they just may feel like a walk in the park!

bi-manual compression

Trivia:
  BUBBLE-LE (stands for Breasts, Uterus, Bladder, Bowels, Episiotomy, Lower
extremities, and Emotions)

https://www.lancastergeneralhealth.org/health-hub-home/motherhood/your-
pregnancy/childbirth-diaries-fundal-massage
 https://www.brilliantbirths.com/blog/what-is-fundal-massage