LEOPOLDS MANUVER RUBRIC

Purpose:
To determine the fetal position and presentation.
To determine the presenting part i.e. lie, attitude, and descent.
To aid in location of fetal heart rates
To aid in assessment of fetal size
To determination of single versus multiple gestation
Perform:
Manuever is preferably performed After 24-26 weeks, when fetal
outline can be palpated.
Total Score: 2 points each steps {30points}

Procedure: Rationale:
Introduce yourself and inform establish rapport, and
pregnant woman about the make the mother
procedure, cooperate with the
assessment
I will do Leopolds Manuever, I'll be
touching your abdomen so that I
can palpate to determine the
position and presentation of the
fetus.
give privacy to the client by closing
the door or the curtains
Instruct Pregnant woman to because she might feel
empty her bladder uncomfortable during
palpation
"would you like to go to the
restroom before we start?"
Assist client in proper positioning "are you comfortable
(supine position, feet on bed and with your position
knees flexed) ma'am?"
- give pillow in her head
Using a blanket cover the body it's because it's the only
and only exposed the abdomen of part that we'll going to
the pregnant woman. assess
Perform hand washing to prevent cross
contamination from the
health provider to the
patient.
Warm hands before palpating the to bring comfort during
abdomen  palpation, because cold
hands might be startling
*in palpation I'm going to use my
and uncomfortable to
palm rather than just fingers
the patient
1st Maneuver: Fundal Grip To determine fetal part
While on the side of woman, lying in the fundus.
palpate the upper abdomen To determine
( Fundus) using both hands , presentation. (cephalic,
palpate using one hand and put breech, compound or
pressure using the other hand. shoulder)
Then repeat it with the other *fetal head should be
hand. round and hard, &
ballottable
*breech presents as a
nodular mass
Note the consistency, shape and
mobility
2nd Maneuver: Lateral Grip/ To identify location of
umbilical grip fetal back.
palpation of paraumbilical areas or To determine position.
the side of the uterus. *normal fetal back feels
Place both palms on either side of like hard, resistant, &
the midline of the abdomen, using convex structure
gentle but deep pressure. Left * fetal small parts feel
hand stay on place while the right nodular & irregular
hand explores, then continue to *Knees and elbows of
repeat it with the other hand. fetus feel with a number
of angular nodulation
Note the consistency
3rd maneuver: Pawlick's Grip To determine
Suprapubic palpation using thumb engagement of
and fingers just above the presenting part. the fetal
symphysis pubis. presentation and station.
Place one hand above the *the presenting part is
symphysis. Grasp the lower part of engaged if it is not
fetus , with thumb on one side and movable.
forefingers on the other sides. It is not yet engaged if it
Attempt gently pushing the fetal is still movable.
part 
4th maneuver: Deep pelvic grip  To determine the degree
it is the palpation of the bilateral of flexion of fetal head.
lower quadrant To determine attitude or
habitus.
Facing the woman feet, place both
hand on the  lower part of *if it's head flexed or
abdomen then move down to side head extended
of uterus towards the pubis Contraindications: 
Deep Pelvic grip is not
needed to be perform if
the presentation is
breech or transverse
(pertaining to the 1st
manuever)
Note the cephalic prominence
relation to fetal back 
*Vertex presentation Good attitude – if brow
Place fingers of the right hand correspond to the side
transversely on fetal head and (2nd maneuver) that
measures the number of fingers
from the pubic bone to the base of and knees.
baby’s head,
Document All findings.
contained the elbows
Poor atitude – if
examining fingers will
meet an obstruction on
the same side as 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)
It is important to note
that all findings are not
truly diagnostic, and as
such ultrasound is
required to conclusively
determine the fetal
position.