LEOPOLD

MANEUVER
FIRST MANEUVER

• To determine if fetal head or breech

is in uterine fundus.
• Palpate sides of uterus and fundus.
• Head feels hard and round, freely
movable and ballotable;
• Breech feels large, nodular, soft.
 
SECOND MANEUVER
• To determine the position of the fetal
extremities, the fetal back, and the anterior
shoulder.
• Place hands ion the sides of the abdomen to
identify the location a of the back and small
parts.
• Palpate down sides of uterus applying gentle
but deep pressure.
• On side of fetal back, along continuous
structure will be felt; side with fetal
extremities will feel nodular, reflecting
portions of fetal extremities.
THIRD MANEUVER
• To determine the portion of the fetus that
is presenting and if engagement has
occurred. Grasp the lower uterine segment
between the thumb and fingers of one hand
to feel the presenting part.
• If presenting part is movable, engagement
has not occurred.
• If engagement has occurred, fetal part
feels fixed in the pelvis.
• The head is at inlet or in pelvis in 90% of
women.
FOURTH MANEUVER

• To confirm the findings of the third

maneuver and to determine the
flexion of the vertex.
• Turn and face the woman’s feet.
• The cephalic prominence is felt on
the side where there is greater
resistance to the descent of the
fingers into the pelvis.
THANK
YOU!