General Features
Age, general comfort
Body Habitus
Weight (change), BMI
Bruising
Oedema
Of the face / arms / legs
Abdominal Size
Scars
Pfannenstiel, other past surgery
Skin
Linea nigra, striae gravidarum, striae albicans
Linea Nigra
Present in most pregnant women
Hyperpigmentation of linea alba in the midline
Striae Gravidarum
'Stretch marks'
Erythematous / purple band-like skin defects
Striae Albicans
Healed stretch marks
Skin coloured band-like defects
Foetal Movement
Normally visible after 24 weeks
Tenderness
Palpate each segment of the abdomen
Symphysis-Fundal Height
Palpate down from xiphisternum to fundus, measure from fundus to symphysis pubis
Leopold's Manoeuvre 1: Fundal Grip
Foetal poles
Place both hands over the fundus
Leopold's Manoeuvre 2: Lateral Grip
Foetal lie
Move hands downward along sides of uterus
Leopold's Manoeuvre 3: Pawlik's Grip
Foetal presentation
Firmly grip presenting part between thumb & index finger
Leopold's Manoeuvre 3: Deep Pelvic Grip
Hands facing downward, feel for foetal head
Myometrium
Soft / hard / contracting
Liquor Volume
Foetal parts subjectively easy or difficult to feel
Foetal Movement
Foetal Heart
Using Pinard's stethoscope or hand-held Doppler
Prepare
Consent, chaperone, undress, position
Cervical Dilatation
Using index finger breadth
Cervical Length
Shortens during labour
Normal 3-3.5cm
Consistency
Soft / medium / firm
Cervical Position
Anterior / posterior
Station
Level of presenting part compared to ischial spines
Foetal Head
Identify anterior fontanelle (diamond) and posterior fontanelle (triangle)
Occiput-anterior (OA) / -posterior (OP) / -lateral (OL)
Liquor
Membranes intact / ruptured, meconium liquor