Maternity Nurses Practices Abdominal Examination, Palpation, and Auscultation at First Stage of Normal Labor: An Instructional Package

Research Abstract

Background: Abdominal examination is crucial in the initial assessment of labor, helping to confirm its onset and assess fetal condition, including lie, presentation, and position. The Leopold maneuvers comprise four steps: identifying fetal lie and presentation, locating the fetal spine, assessing engagement of the presenting part, and confirming fetal position by locating the forehead and occiput in the lower abdomen. Aim: evaluate how an instructional package influenced nursing practices in general procedures, abdominal examination, palpation, and auscultation of fetal heart rate during the first stage of normal labor. Subjects and Methods: Design: A quasi-experimental design with a one group pre-posttest. Setting: labor unit at Beni-Suef University and Beni-Suef Specialist Hospitals. Sample: A convenience sample consisting of 50 maternity nurses. Tools: Observational checklist: Part I: checklist used to assess the general practices. Part II: checklist of performing abdominal examination. Part III: The checklist of performing Leopold's maneuvers. Part IV: The checklist of performing auscultation fetal heart rate. Results: 30% of nurses filled out admission card information pre-instruction compared to 80 post-one. Also, 40% of the nurses had position women in a dorso-recumbent position pre-instruction while 80% were done post-one, p value ≤0.001 for all sub item of abdominal examination. Moreover, 68.0% of nurses did not auscultate fetal heart rate pre-instruction compared to 12.96% post-one. Moreover, it shows that there were highly statistically significant differences for all items of the studied maternity nurses’ reported practices regarding performing Leopold's maneuver items at p-value ≤0.001 between pre- and post-instructional package implementation. Conclusion: There was a significant improvement in maternity nurses' practices concerning nursing care in the first stage of normal labor, covering general practices, fetal heart rate auscultation, abdominal palpation, and post-instruction examination. Recommendations: Implementing a periodic in-service training program aims to enhance maternity nurses' practices for abdominal and vaginal examination, and auscultation of fetal heart rate

Research Keywords

maternity nurses' practices; first stage of normal labor; abdominal examination; palpation; auscultation, instructional package