LEOPOLD’S MANEUVER

Standard palpation of the

abdomen for assessing the
fetal position, presentation
and degree of descent.

The aim of Leopold

maneuvers is to determine
the fetal presentation and
position by systematically
palpating the gravid
abdomen.
PURPOSE OF LEOPOLD’S MANEUVER
Determine the number of fetus.

Identify the presentation, position, degree of descent and

attitude of the fetus.

Identify the point of maximum intensity of fetal heart

tone in relation to the woman’s abdomen.
MATERIALS NEEDED:
Pillow

Tape Measure (to measure fundic height)

Stethoscope (to locate the fetal heart beat)

Pre-procedure checks!
STEPS RATIONALE
1. Check the client’s chart: To ensure that you’re administering the procedure
Read the Doctor’s order for the said procedure. to the right client.
Client’s conditions and restrictions.

2. *Do client Assessment: To gather data would make computation accurate.

Obtains obstetrical history including parity, gravida
score, LMP, EDC and AOG.
Fundic Height.

*Take the vital signs
3. Explain the procedure to the client.
4. Instruct the client to empty her bladder before
performing the procedure.
To baseline data prior to doing the procedure for
comparison purpose.
To elicit cooperation of the client. It reduces
apprehension and encourages cooperation.
To avoid discomfort to the client and provide
relaxation during the procedure.
Pre-procedure checks!
STEPS RATIONALE
5. Gather the needed equipment and check for its To be organize promotes efficient time
completeness. management.
6. Do hand washing prior the procedure. To do handwashing deters the spread of pathogens.
7. Provide for client privacy. To ensure cooperation of the client during the
procedure.
PROCEDURE PROPER
STEPS RATIONALE8.
8. Place woman in dorsal recumbent position or To have easy access during the maneuver, to make
supine with knees flexed to relax abdominal client more comfortable and gain cooperation.
muscles. Drape the client using the tap
sheet/blanket exposing only the abdomen and place
a pillow under her head.
9. Make sure that the hands are warm before To do handwashing deters the spread of pathogens.
coming in contact with the client’s abdomen.
Rub the hands together vigorously to prevent
uterine contractions and use the palm of the
hand instead of the fingers.

Dorsal Recumbent
 STEPS RATIONALE8.
10. 1st Maneuver: Fundal Grip

Using both hands and facing the client, feel for the To avoid over reaching of the clients abdomen and
fetal part lying in the fundus. Determine the shape, able to palpate the fundus and feel the parts lying
size, mobility, and consistence of what is being under.
palpated.

Findings:
Head is more firm, hard and round that moves
independently of the body.
Breech is less well defined that moves only in
conjunction with the body.
 STEPS RATIONALE8.
11. 2nd Maneuver: Umbilical Grip

One hand is used to steady the uterus on one side To use both hand in palpating aid in correct findings
of the abdomen while the other hand moves slightly during the 2nd maneuver.
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.
Repeat this step on the opposite side using the
opposite hand.

Findings:
Fetal back is smooth, hard, and resistant surface
Knees and elbows of fetus feel with a number
of angular nodulations
 STEPS RATIONALE8.
12. 3rd Maneuver: Pawlik’s Grip

• Using thumb and finger, grasp the lower The usage of thumb and finger would help in the
portion of the abdomen above symphysis determination of the presenting part either engage
or not engage yet.
pubis, press in slightly and make gentle
movements from side to side.
▪ Findings:
• The presenting part is not engaged if it is not
movable.
• It is not yet engaged if it is still movable.
 STEPS RATIONALE8.
14. Fourth Maneuver: Pelvic Grip

Facing foot part of the woman, palpate fetal head To avoid over reaching of the woman’s abdomen.
pressing downward about 2 inches above the
inguinal ligament.
Use both hands.
Findings:
Good attitude – if brow corresponds to the side (2nd
maneuver) that contained the elbows and knees.
Poor attitude – 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)
 STEPS RATIONALE8.
14. Place client to its proper and comfortable To make client relax after the procedure.
position.
15. Do hand washing. To Reduces transmission of microorganism
16. Document the procedure and assessment during A careful record is important for documentation
the care. after client care.
Reporting and recording of information about the
procedure must be accurate and timely for
continuity of care.