How to Perform Leopold’s Maneuver

BY DAISY JANE ANTIPUESTO RN MN · JULY 10, 2008

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
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.
7. Purpose Procedure Findings

Head is more firm, hard and round

To determine
Using both hands, that moves independently of the
fetal part lying in
First Maneuver: feel for the fetal body.
the fundus.To
Fundal Grip
determine
part lying in the Breech is less well defined that
fundus. moves only in conjunction with the
presentation.
body.
Second To identify One hand is used Fetal back is smooth, hard, and
Maneuver: location of fetal to steady the resistant surface
Umbilical Grip back. uterus on one side Knees and elbows of fetus feel
To determine of the abdomen with a number of angular nodulation
position. 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 but
deep pressure.
Using thumb and
finger, grasp the
lower portion of
Third To determine the abdomen The presenting part is not engaged
Maneuver: engagement of above symphisis if it is not movable.It is not yet
Pawlik’s Grip presenting part. pubis, press in engaged if it is still movable.
slightly and make
gentle movements
from side to side.
Good attitude – if brow correspond
Facing foot part to the side (2nd maneuver) that
of the woman, contained the elbows and knees.
To determine the
palpate fetal head Poor atitude – if examining fingers
degree of flexion
Fourth pressing will meet an obstruction on the
of fetal head.To
Maneuver: downward about same side as fetal back
determine
Pelvic Grip 2 inches above (hyperextended head)Also palpates
attitude or
the inguinal infant’s anteroposterior position. If
habitus.
ligament. brow is very easily palpated, fetus is
Use both hands. at posterior position (occiput
pointing towards woman’s back)