LEOPOLD’S MANEUVER

Name: Buscas,Maria Theresa Grade:__________________________

Year and Section: BSN 2N Date:

.

PROCEDURE RATIONALE 1 2 3 4 5
PREPARATION Legend:
1. Wash hands. 1- Excellent
To remove dirt and
microorganism. 2- Very Satisfactory
2. Encourage the patient to empty the bladder. 3- Satisfactory
Doing so promotes
4- Needs
comfort and allows for Improvement
more productive5- Poor
palpation because fetal
contour will not be
obscured by a
distended bladder.
3. Compute the following: Ob score refers to the
a. OB Score gravidity and parity are
b. EDC the number of times a
c AOG woman.
4. Physical Assessment EDC refers to the due
date or estimated
calendar date when a
baby will be born.
AOG is the common
term used during
pregnancy to describe
how far along the
pregnancy is.
Physical examination is
the process of
evaluating objective
anatomic findings
through the use of
observation, palpation,
percussion, and
auscultation.
First Maneuver
1.Position the patient To keep the patient
comfortable and have
better access to the
abdomen of the client.
2. Stand at the side of the bed, facing the mother. Proper positioning of
hands ensures
accurate findings.
3 Palpate the uterine fundus with warm hands. Handwashing prevents
 the spread of possible
infection. Using warm
water aids in client
comfort and prevents
tightening of
abdominal muscles.
4. Determine which part of the baby’s body lies on When palpating, a
the upper fundus according to its: head feels firmer than
a. Relative consistency a breech. A head is
b. Shape round and hard; the
c. Mobility breech is less well
defined. A head moves
independently of the
body; the breech
moves only in
conjunction with the
body.
Second Maneuver
1. Place the palmar surface of both hands on either Proper positioning of
side of the abdomen. hands ensures
accurate findings.
2. Apply gently but deep pressure in one side of the Deep pressure will
abdomen. have a better
palpitation of the
abdomen
3. Palpate the opposite side from the top to the This method is most
lower segment of the uterus in a slightly circular successful to
motion. determine the
direction the fetal back
is facing. One hand will
feel a smooth, hard,
resistant surface (the
back), while on the
opposite side, a
number of angular
nodulations (the knees
and elbows of the
fetus) will be felt.
4. Determine which side of the uterus is the long axis This method is most
of the fetus located. successful to
determine the
direction the fetal back
is facing. One hand will
feel a smooth, hard,
resistant surface (the
back), while on the
opposite side, a
 number of angular
nodulations (the knees
and elbows of the
fetus) will be felt
5. Check the fetal heart rate fetal heart rate may
change as the fetus
responds to conditions
in your uterus.
Third Maneuver
1. Grasp the lower uterine segment with thumb and If the presenting part
fingers. moves upward so an
examiner’s hands can
be pressed together,
the presenting part is
not engaged (not firmly
settled into the pelvis).
If the part is firm, it is
the head; if soft, then it
is the breech.
2. Identify the presenting part. If the presenting part
moves upward so an
examiner’s hands can
be pressed together,
the presenting part is
not engaged (not firmly
settled into the pelvis).
If the part is firm, it is
the head; if soft, then it
is the breech.
3. Determine the mobility of the presenting part. If the presenting part
moves upward so an
examiner’s hands can
be pressed together,
the presenting part is
not engaged (not firmly
settled into the pelvis).
If the part is firm, it is
the head; if soft, then it
is the breech.
Fourth Maneuver
1. Stand to the side facing the patient’s feet. Proper positioning of
hands ensures
accurate findings.
2. Place the tips of the first three fingers on both The fingers of one
sides of the midline about two inches from the hand will slide along
inguinal ligament. the uterine contour
and meet no
 obstruction, indicating
the back of the fetal
neck. The other hand
will meet an
obstruction an inch or
so above the ligament
—this is the fetal brow.
3. Apply pressure downward and in the direction of . The fingers of one
the birth canal. hand will slide along
the uterine contour
and meet no
obstruction, indicating
the back of the fetal
neck. The other hand
will meet an
obstruction an inch or
so above the ligament
—this is the fetal brow.
4. Confirm the presenting part. The position of the
fetal brow should
correspond to the side
of the uterus that
contained the elbows
and knees of the fetus.
If the fetus is in a poor
attitude, the examining
fingers will meet an
obstruction on the
same side as the fetal
back. That is, the
fingers will touch the
hyperextended head. If
the brow is very easily
palpated (as if it lies
just under the skin),
the fetus is probably in
a posterior position
(the occiput is pointing
toward the woman’s
back).
ATTITUDE
1. Accepts constructive suggestions and criticisms Suggestions and
criticism help to give us
a new perspective and
opens our eyes to
things we may have
overlooked or never
 considered.
2. Assume responsibility of his or her actions. It is the nurse
obligation and
responsibility to do
their job. Assuming
accountability will
make space for
improvement.
Scoring:
1x ____________ = __________
2x ____________ = __________
3x ____________ = __________
4x ____________ = __________
5x ____________ = __________
Total divided by no. of items = __________
Comments:
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Student’s Signature over Printed Name Clinical Instructor’s Signature and Date over Printed name