CHECKLIST SCRIPT

1.Gather all equipment needed. Check Institutional Before I enter the room, I will first gather all the
Policies regarding consent and privacy of clients for equipment needed. I will also check the institutional
Leopold’s Maneuver. policies regarding consent and privacy of clients for
Leopold’s Maneuver.

2.Explain with understanding the importance of Then, I will explain with understanding the importance
privacy in doing the procedure, especially for male of privacy in doing the procedure, especially for male
examiners. examiners.

3.Explain the rationale for each material used. The materials to be used are:
a. tape measure
b. doppler/stethoscope/ fetoscope a. tape measure - to measure fundic height
c. lubricant/KY Jelly b. doppler/stethoscope/ fetoscope - to detect the fetal
d. Tissue paper heart beats/tone
e. Plastic container c. lubricant/KY Jelly - to lubricate the abdomen
d. Tissue paper - to wipe the jelly after the procedure
e. Plastic container - to discard the used jelly and
tissue paper

4.Introduce yourself, check the identification band, Good morning po! I am Dawn Mariel V. Catibog, your
wash hands, ask the patient to empty her bladder, student nurse for today.
Explain to the client their level of understanding of the
procedure. I will be doing the leopold’s maneuver.

Before anything else, can you tell me your name and

birthday? May I check it in your wristband? Okay.

Hi Mam/Sir _____ How are you feeling today? That’s

good to know.

This assessment allows us to observe and palpate the

abdomen to know the fetal presentation, fetal
position, fetal attitude, fetal lie and degree of
engagement. This method of abdominal palpation is of
low cost, easy to perform, and non-invasive.

As I do the procedure, I will ask you from time to time

if you are comfortable, okay? I’ll do my job well to
provide you the best comfort you need.

I’ll be touching some parts of your body. Will you allow

me to begin it now?

Thank you!

I will be asking you to empty your bladder while I do


5.Provide privacy, exposing only the abdomen to be
assessed.
6.Adjust the bed to a comfortable height. Drape the
patient properly to maintain privacy. Place a small
pillow under the head for comfort. Place the patient in
a dorsal recumbent position, supine with the knee
flexed.
7. Measure fundic height and appreciate fetal heart
tone. Warm hands first by rubbing them together
before placing them over the patient’s abdomen to aid
comfort. --Identify proper placement of doppler or
stethoscope for the determination of FHT.
Assess if FHT is within Normal range (must know the
normal range and know when to report abnormal
findings)
8. Check and obtain Fetal Heart rate using a
stethoscope or Doppler. Explain the importance of
knowing how to use the stethoscope as a basic tool in
obtaining FHT.
9.Explain briefly the correlation of the fundic height to
the AOG of the client.
10. PERFORM THE FIRST MANEUVER.
Palpate fundal area to determine which fetal part is
located in the uterine fundus.
a. Stands at the side of the bed, facing the client
b. Using both hands, feel for the fetal part lying in
some safety precaution such as hand hygiene.
Now, I will be closing the curtains for privacy.
I will be exposing only your abdomen later on.
Then, I will adjust the bed to a comfortable height.
I will be exposing and draping your abdomen to
maintain privacy.
Then, placing a small pillow under your head for
comfort.
Afterwards, I will be positioning you in a comfortable
position which is the dorsal recumbent position,
supine with the knee flexed.
I will be warming my hands first by rubbing them
together before placing on your abdomen.
Now, I will be measuring the fundic height from the
symphysis pubis to the fundus and obtain the fetal
heart tone using a stethoscope.
The normal fetal heart tone is 120-160 bpm. At the
20th week, the fetal heart tone is audible in an
ordinary stethoscope. Incase the FHT is abnormal, then
report immediately to the attending physician for
further treatment and medication.
I will be checking and obtaining the fetal heart rate
using this stethoscope.
It is important to know how to use the stethoscope to
listen to the sounds produced by the heart, lungs and
other internal organs. If an abnormal sound was heard,
then it could indicate cardiac or circulation issues
which needs immediate attention from the doctor.
After the 24th week of pregnancy, the fundal height of
a properly developing baby is anticipated to be equal
to the number of weeks of pregnancy, plus or minus 2
cm. For instance, if you are 28th weeks pregnant, your
health care provider would expect that you have a
fundal height of 28cm.
(perform the first maneuver)
fundal grip
the fundus.

GIVE THE FINDINGS:

Fetal head: firm, hard, and round

Explain Fetal Presentation

11. PERFORM THE SECOND MANEUVER. umibilical grip

Locate/identify the fetal back in relation to the right

and left sides of the mother.

Hold R hand still and with deep but gentle pressure,

use L hand to feel for the firm, smooth back.

GIVE THE FINDINGS.

Small fetal parts (knees and elbows) feel nodular with

numerous angular nodulations.

Back feels smooth, hard, like a resistant surface. (May

determine the FHT in this stage as instructed

Explain Fetal Lie

12. PERFORM THE THIRD MANEUVER. pawlicks grip

Determine if the presenting part has entered the pelvis
(engagement of presenting part)
Grasp the lower portion of the abdomen (just above
symphysis pubis) with the thumb and fingers of the
Right hand.

GIVE THE FINDINGS.

Head will feel firm. Buttocks will feel softer and

irregular.

Explain Fetal Engagement

13. PERFORM THE FOURTH MANEUVER. pelvic grip

Assess descent of the presenting part. Palpate for the

cephalic prominence (vertex)

GIVE THE FINDINGS.

Prominence on the same side as the small parts

suggests that the head is flexed (optimum)
Prominence on the same side as the back suggests
that the head is extended. Breech/buttocks: softer and
has bony prominences

Explain Fetal Attitude

14. Evaluate the patient’s reaction to the procedure.
Reposition the client comfortably on the bed. Return
all materials to the proper places. Wash hands
properly. Accomplish pre-natal assessment data form
correctly and documented findings accurately.
How are you feeling po?
Thank you for your cooperation. So far, I have noted
the findings and we have completed the procedure.
I will just reposition you comfortably on the bed.

I will clean all the equipment and return all materials

into proper places.

I will discard my gloves and do hand hygiene again.

Lastly, I will accomplish the pre-natal assessment data

form and document any unusual findings and report all
findings to the attending physician. That’s all. Thank
you po!

15. Reports in uniform with proper grooming and

displays correct decorum, observes work ethics, and
shows resourcefulness, manifests great confidence in
his/her work, shows diligence in documenting
observations.