LEOPOLD’S MANEUVER

Leopold’s 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
relaxabdominal 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.
 Steps Purpose Procedure Findings

To determine fetal Using both Head is more firm, hard and round
part lying in the hands, feel for that moves independently of the
fundus.To the fetal part body. Breech is less well defined that
First Maneuver: determine lying in the moves only in conjunction with the
Fundal Grip presentation. fundus. body.

Second To identify One hand is used Fetal back is smooth, hard, and
Maneuver: location of fetal to steady the resistant surface Knees and elbows of
 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
parts. Use gentle
back. To determine but deep fetus feel with a number of angular
Umbilical Grip position. pressure. nodulation

Using thumb and

finger, grasp the
lower portion of
the abdomen
above symphisis
pubis, press in
slightly and make
Third To determine gentle The presenting part is notengaged if it
Maneuver: engagement of movements from is not movable.It is not yet engaged if
Pawlik’s Grip presenting part. side to side. it is still movable.

Good attitude – if brow correspond to

the side (2nd maneuver) that
Facing foot part contained the elbows and knees. Poor
of the woman, atitude – if examining fingers will
palpate fetal head meet an obstruction on the same side
pressing as fetal back (hyperextended
To determine the downward about head)Also palpates infant’s
degree of flexion 2 inches above anteroposterior position. If brow is
Fourth of fetal head.To the inguinal very easily palpated, fetus is at
Maneuver: determine attitude ligament. Use posterior position (occiput pointing
Pelvic Grip or habitus. both hands. towards woman’s back)