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)