Question

Describe how the obstetrics would perform a physical assessment on the uterus of a mother immediately after delivery. Describe how you would assess the following reflexes: tonic neck, moro, and babinski reflexes.

Answer 1

POSTPARTUM ASSESSMENT OF UTERUS

The fundus is assessed for:

• By approximately one hour post delivery, the fundus is firm and at the level of the umbilicus.
• The fundus continues to descend into the pelvis at the rate of approximately 1 cm or finger-breadth per day and should be nonpalpable by 14 days postpartum.

In addition, patients are assessed for uterine cramping and treated for pain as needed.
Patients or a family member can be taught to assess the firmness of the fundus and to provide massage in the event of a boggy uterus or excessive bleeding. Patients are encouraged to void before palpation of the uterine fundus because a full bladder displaces the uterus and can lead to excessive bleeding.

Tonic neck reflex

When a baby's head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. This is often called the fencing position. This reflex lasts until the baby is about 5 to 7 months old.

Moro reflex

The Moro reflex is often called a startle reflex. That’s because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out his or her arms and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him or her and trigger this reflex. This reflex lasts until the baby is about 2 months old.

Babinski reflex

This reflex is one of the normal reflexes in infants. Reflexes are responses that occur when the body receives a certain stimulus. The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot.

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