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Leopolds Maneuver is preferably performed after 24 weeks gestation when fetal

outline can be already palpated.

1. Instruct woman to empty her bladder first.


2. Place woman in dorsal recumbent position, supine with knees flexed to relax
abdominal muscles. Place a small pillow under the head for comfort.
3. Drape properly to maintain privacy.
4. Explain procedure to the patient.
5. Warms hands by rubbing together. (Cold hands can stimulate uterine
contractions).
6. Use the palm for palpation not the fingers

Purpose Procedure Findings

Head is more firm,


hard and round that
To determine fetal part moves independently
Using both hands, feel
First Maneuver: lying in the fundus. of the body.
for the fetal part lying in
Fundal Grip To determine Breech is less well
the fundus.
presentation. defined that moves
only in conjunction with
the body.

One hand is used to


steady the uterus on one
side of the abdomen
Fetal back is smooth,
while the other hand
hard, and resistant
moves slightly on a
To identify location of surface
Second Maneuver: circular motion from top
fetal back. Knees and elbows of
Umbilical Grip to the lower segment of
To determine position. fetus feel with a
the uterus to feel for the
number of angular
fetal back and small fetal
nodulation
parts.
Use gentle but deep
pressure.
Using thumb and finger,
grasp the lower portion The presenting part
To determine of the abdomen above is not engaged if it is
Third Maneuver:
engagement of symphysis pubis, press not movable. It is not
Pawliks Grip
presenting part. in slightly and make yet engaged if it is still
gentle movements from movable.
side to side.
Good attitude if
brow correspond to the
side (2nd maneuver)
that contained the
elbows and knees.
Poor atitude if
Facing foot part of the
examining fingers will
To determine the woman, palpate fetal
meet an obstruction on
degree of flexion of head pressing
Fourth Maneuver: the same side as fetal
fetal head. downward about 2
Pelvic Grip back (hyperextended
To determine attitude inches above the
head) Also palpates
or habitus. inguinal ligament.
infants anteroposterior
Use both hands.
position. If brow is very
easily palpated, fetus is
at posterior position
(occiput pointing
towards womans
back)