Nurses use the 

Leopold Maneuvers when caring for their pregnant patients. Nurses

must remember to perform 4 specific actions as a part of these methods. The skill of
the individual performing the maneuvers is critical to determining if the fetus is in the
correct position so it is very important that nurses learn to execute the Leopold
Maneuvers correctly

 Steps on How to Perform Leopold Maneuvers

Maneuver One: Fundal Grip

1. Using both hands and facing the patient, palpate the upper abdomen. The nurse
should use this method to determine the shape, size, mobility, and consistence
of what he or she feels. The nurse should feel that the limbs and shoulders
contain little bone processes that move with the fetus’ trunk; the head is firm,
hard, round and moves separately from the trunk; and the buttocks is symmetric
and feels soft.

Maneuver Two: Umbilical Grip

2.     After the nurse identifies the form and palpates the upper abdomen, the location
of the fetus’ back must be identified.

3.     While still facing the patient, the nurse should apply deep pressure with the palm
of his or her hands to palpate the abdomen gently. Perform this maneuver by placing
the right hand on one side of the patient’s abdomen while using the left hand to
explore the woman’s uterus on the right side. Repeat this step on the opposite side
using the opposite hand.

4.     The nurse should observe that the fetal back is smooth and firm. The extremities
of the fetus should feel like protrusions and small irregularities. The back should
connect with the form felt in the lower (maternal inlet) and upper abdomen.
Maneuver Three: Pawlick’s Grip

5.     During this step of the process, the nurses must identify the part of the fetus that
is above the inlet. The nurse must use the fingers and thumb on the right hand to grasp
the lower abdomen area located above the pubic symphysis. The findings should
validate what is determined in the first maneuver.

6.      The two- hand approach is an alternative that is more comfortable for the
patient. Nurses can perform this approach by positioning the fingers of both hands in
a lateral position on one side of the presented part.

Maneuver Four: Pelvic Grip

7.     This step should be done while facing the patient’s feet. The process involves
locating the fetus’ brow. The nurse should gently move the fingers on both hands
toward the pubis by sliding the hands over the sides of the patient’s uterus, and the
side where the greatest resistance to the descending fingers is the location of the brow.
A well-flexed fetal head is located on the opposite side of the fetal back. If the head is
extended, the back of the head is felt on the side that the back is located. A head that
cannot be felt has likely descended.

Tips for Performing Leopold Maneuvers

 Instruct the female to empty her bladder before performing the maneuver so
that she will be comfortable and the contour of the fetus is not obscured.
 Put the woman in a comfortable position with her knees flexed. Drape the
patient and place a pillow under her head. Explain the procedure to the patient
and answer any questions that she may have.
 Make sure that the hands are warm before coming in contact with the patient’s
abdomen. Rub the hands together vigorously to prevent uterine contractions and
use the palm of the hand instead of the fingers.
 The nurse should stand with the body facing the patient during the first three
maneuvers and facing the feet of the patient during the final maneuver.