4.

Leopold’s Maneuver – is a systematic method of observation and palpation to determine fetal

presentation and position and it is done as part of physical examination.
4.1 Leopold’s Maneuver

MANEUVER PURPOSE PROCEDURE FINDINGS

L1: To determine fetal Stand at the foot of Head - more firm,

part lying in the the woman facing hard and round that
Fundal Grip fundus. her, and place both moves independently
hands flat on her of the body
To determine abdomen. Palpate
presentation. the superior surface Breech - less well
of the fundus. defined that moves
Determine only in conjunction
consistency, shape with the body
and mobility.

L2: To identify location of Face the woman, Fetal back - smooth,

fetal back. hold the left hand hard resistant
Umbilical Grip stationary to the left surface
To determine side of the uterus
position. while you palpate Knees and elbows –
with the right hand feel with a number of
on the opposite side angular nodulation
of the uterus from top
to bottom. Repeat
palpation using the
opposite side.

L3: To determine Gently grasp the The presenting part

engagement of lower portion of the is engaged if it is not
Pawlick’s Grip presenting part abdomen just above movable. It is not yet
the symphysis pubis engaged if it is
between the thumb movable.
and fingers and try to
press the thumb and
fingers together.
Determine any
movement and
whether the part
feels firm or soft.

L4: To determine the Place fingers on both Good attitude if brow

degree of flexion of sides of the uterus correspond to the side
Pelvic Grip fetal head. approximately 2 in. (2nd maneuver) that
above the inquinal contained the elbows
To determine attitude ligaments, pressing and knees.
of habitus downward and
inward in the Poor attitude if
direction of the birth examining fingers will
canal. Allow fingers meet an obstruction
to be carried on the same side as
downward. fetal back
(hyperextended
head).

– also palpates
infant’s
anteroposterior
position. If brow is
very easily palpated,
fetus is at posterior
position (occiput
pointing towards
woman’s back).