Leopolds Maneuver

is preferably performed after 24 weeks gestation when fetal outline can be already palpated. Preparation: 1. Instruct woman to empty her bladder first. 2. Place woman in dorsal recumbent position, supine with knees flexed to relax abdominal muscles. Place a small pillow under the head for comfort. 3. Drape properly to maintain privacy. 4. Explain procedure to the patient. 5. Warms hands by rubbing together. (Cold hands can stimulate uterine contractions). 6. Use the palm for palpation not the fingers.

Purpose First To Maneuver: determine Fundal fetal part Grip lying in the fundus. To

Procedure Findings Using both Head is more hands, feel firm, hard and for the fetal round that part lying in moves the fundus. independently of the body.

determine presentation.

Second To identify Maneuver: location of Umbilical fetal back. Grip To determine position.

One hand is used to steady the uterus on one side of the abdomen while the other hand moves slightly on a circular motion from top to the lower segment of the uterus to feel for the fetal back and small fetal

Breech is less well defined that moves only in conjunction with the body. Fetal back is smooth, hard, and resistant surface Knees and elbows of fetus feel with a number of angular nodulation

parts. Use gentle but deep pressure. Third To Using The presenting Maneuver: determine thumb and part Pawliks engagement finger, is notengaged Grip of presenting grasp the if it is not part. lower movable. portion of It is not yet the engaged if it is abdomen still movable. above symphisis pubis, press in slightly and make gentle movements from side to side. Fourth To Facing foot Good Maneuver: determine part of the attitude if Pelvic the degree woman, brow Grip of flexion of palpate correspond to fetal head. fetal head the side (2nd

To determine attitude or habitus.

pressing downward about 2 inches above the inguinal ligament. Use both hands.

maneuver) that contained the elbows and knees. Poor atitude if examining fingers will meet an obstruction on the same side as fetal back (hyperextended head) Also palpates infants anteroposterior position. If brow is very easily palpated, fetus is at posterior position (occiput pointing towards womans back)