North American Registry of Midwives (NARM) Practice Exam

What do you determine from the first Leopold's maneuver?

1. The fetal heart rate

2. The presenting part

3. The amount of amniotic fluid

4. The fetal heart's position

The correct answer is: The presenting part

The first Leopold's maneuver is primarily used to determine the position of the fetus in the uterus, specifically identifying the presenting part. During this maneuver, the caregiver palpates the upper part of the uterus to ascertain which fetal part is occupying the fundus. This helps in understanding whether the head or buttocks are positioned at the top, which is crucial for assessing the fetal position and planning for the labor and delivery process. Knowing the presenting part is essential as it influences the course of labor and the delivery method that may be required. The other options, while related to aspects of the fetal assessment, do not directly pertain to the information gained from the first Leopold's maneuver. For instance, fetal heart rate and position are assessed through different means, such as Doppler ultrasound or fetal monitoring, and the amount of amniotic fluid is evaluated through ultrasound rather than palpation alone. Therefore, the first Leopold's maneuver simplifies the assessment process by providing a clear understanding of which fetal part is presenting for delivery.