North American Registry of Midwives (NARM) Practice Exam

Which maneuver is used to check for placental separation?

1. Modified Brandt-Andrews maneuver

2. Leopold's maneuver

3. Valsalva maneuver

4. Harris maneuver

The correct answer is: Modified Brandt-Andrews maneuver

The Modified Brandt-Andrews maneuver is specifically designed to assist in assessing placental separation after childbirth. This technique involves gently applying pressure to the uterus while simultaneously encouraging the mother to either push or bear down. By doing this, the healthcare provider can evaluate whether the placenta has detached from the uterine wall, which is crucial for the overall assessment of postpartum hemorrhage risk. The importance of confirming placental separation is significant as retained placenta can lead to serious complications, such as excessive bleeding or infection. Therefore, the Modified Brandt-Andrews maneuver serves as a practical and effective way to monitor this vital phase of the postpartum process. Other maneuvers, such as Leopold's, are focused on fetal positioning and are not suited for evaluating placental status. The Valsalva maneuver, often associated with increasing intra-abdominal pressure, is not utilized in the context of placental separation, while the Harris maneuver does not specifically pertain to this aspect of postpartum care. Understanding these distinctions is crucial for effective midwifery practice and management of the postpartum period.