Leopold's Maneuver

P are a systematic method of

observation and paIpation 9o
de9ermine fe9al posi9ion, presen9a9ion, lie
and a99i9ude which helps in predic9ing
course of labor.
P Leopold's Maneuver is preferably
performed af9er 24 weeks ges9a9ion
when fe9al ou9line can be already
palpa9ed.
!705,7,943
P ns9ruc9 woman 9o emp9y her bladder firs9.
P Place woman in dorsal recumben9 posi9ion,
supine wi9h knees flexed 9o relax abdominal
muscles. Place a small pillow under 9he
head for comfor9.
P Drape properly 9o main9ain privacy.
P Explain procedure 9o 9he pa9ien9.
P Warms hands by rubbing 9oge9her. (Cold
hands can s9imula9e u9erine con9rac9ions).
P Use 9he palm for palpa9ion no9 9he fingers.
First Maneuver: undal Grip
Purpose:
P %o de9ermine fe9al par9 lying in 9he fundus.
P %o de9ermine presen9a9ion.
Procedure
Using bo9h hands, feel for 9he fe9al par9
lying in 9he fundus.
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P ead is more firm, hard and round 9ha9
moves independen9ly of 9he body.
P
reech is less well defined 9ha9 moves
only in conjunc9ion wi9h 9he body.
Second Maneuver:
Umbilical Grip
Purpose: %o iden9ify loca9ion of fe9al back.
%o de9ermine posi9ion.
Procedure:
One hand is used 9o s9eady 9he u9erus on one
side of 9he abdomen while 9he o9her hand
moves sligh9ly on a circular mo9ion from 9op 9o
9he lower segmen9 of 9he u9erus 9o feel for 9he
fe9al back and small fe9al par9s.
Use gen9le bu9 deep pressure.
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P one hand: will feel smoo9h, hard
resis9an9 surface the fetaI back)
P
9he opposi9e side, a number of angular
nodula9ion knees and eIbows of fetus
Third Maneuver: PawIik's Grip
Purpose: %o de9ermine engagemen9 of
presen9ing par9.
Procedure:
Using 9humb and finger, grasp 9he lower por9ion
of 9he abdomen above symphisis pubis, press in
sligh9ly and make gen9le movemen9s from side
9o side.
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P %he presen9ing par9 is engaged if i9 is
no9 movable.
P 9 is no9 ye9 engaged if i9 is s9ill movable.
4. our9h Maneuver: Pelvic Grip
Procedure
P %o de9ermine fe9al descen9, 9he degree of
flexion of fe9al head.
P %o de9ermine a99i9ude or habi9us.
Procedure:
P acing foo9 par9 of 9he woman, palpa9e fe9al
head pressing downward abou9 2 inches
above 9he inguinal ligamen9.
P Use bo9h hands
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P Good attitude if brow correspond 9o 9he
side (2nd maneuver) 9ha9 con9ained 9he
elbows and knees.
P Poor attitude if examining fingers will
mee9 an obs9ruc9ion on 9he same side as
fe9al back (hyperex9ended head).
P also palpa9es infan9s an9eropos9erior
posi9ion. f brow is very easily palpa9ed,
fe9us is a9 pos9erior posi9ion (occipu9
poin9ing 9owards womans back).