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Obstetric abdominal examination

Inspection, palpation, auscultation — in order.

Source: RCOG GTG 31 · TeachMeObGyn
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Steps

  1. Introduce, consent, chaperone; ask her to empty bladder.
  2. Position semi-recumbent (15–45°); left tilt if lying long.
  3. General look; hands (oedema, pulse), face (pallor, jaundice).
  4. Inspect abdomen: distension, fetal movements, scars, linea nigra, striae.
  5. Palpate all regions for tenderness; feel uterine borders.
  6. Measure SFH (from 24 weeks) — fundus to symphysis, tape markings hidden.
  7. Leopold’s grips: lie, presentation, position, engagement.
  8. Assess liquor (tense / reduced).
  9. Auscultate fetal heart over anterior shoulder for 1 min with maternal pulse (110–160 bpm).
  10. Complete: BP, urine dipstick, oedema, reflexes.
Refer for growth scan if a single SFH is below the 10th centile or serial SFH flattens. Use serial scans if SFH unreliable (BMI >35, big fibroids, polyhydramnios).
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.