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Leopold Maneuvers | How to

Correctly Perform Leopold
Maneuvers Clinical Nursing
Skills
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.

What are Leopold Maneuvers?

The Leopold Maneuvers are used to help

nurses determine fetus’ presentation and
position. The maneuvers have 4 specific
actions that nurses must perform. Nurses
use this process along with the
assessment of the maternal pelvis’ shape
to determine if complications will occur
during the delivery and if the patient will
require a Cesarean section.

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.

Video on How to Perform Leopold

Maneuvers

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.

Common Side Effects and

Complications from Performing
Leopold Maneuvers

There are virtually no side effects or

complications of the Leopold Methods. A
skilled nurse should execute the
procedure and care should be taken not
to disturb the fetus in an excessive
manner. The method can be painful for
the expectant mother if the nurse
performing the maneuvers is does not
take care to perform the procedure
properly.

Performing the 4 steps of the Leopold

Maneuvers requires skill and patients to
locate the position of the mother’s fetus.
The maneuvers should be performed in a
manner that is comfortable to the
expectant mother.

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