LEOPOLDS MANUEVER

Preparation: 1. %. ). +. ,. 2. Instruct woman to empty her !a""er #$rst. P!ace woman $n "orsa! recum ent pos$t$on& sup$ne w$th 'nees #!e(e" to re!a( a "om$na! musc!es. P!ace a sma!! p$!!ow un"er the hea" #or com#ort. Drape proper!y to ma$nta$n pr$*acy. E(p!a$n proce"ure to the pat$ent. -arms han"s y ru $n. to.ether. /0o!" han"s can st$mu!ate uter$ne contract$ons1. Use the pa!m #or pa!pat$on not the #$n.ers.

Purpose First Maneuver: To determine Fundal Grip fetal part lying in the fundus. To determine presentation.

Procedure Using both hands, feel for the fetal part lying in the fundus.

Findings Head is more firm, hard and round that moves independently of the body. Breech is less well defined that moves only in conjunction with the body. Fetal back is smooth, hard, and resistant surface Knees and elbows of fetus feel with a number of angular nodulation

econd Maneuver: Umbilical Grip

To identify location of fetal bac!. To determine position.

"ne hand is used to steady the uterus on one side of the abdomen while the other hand moves slightly on a circular motion from top to the lower segment of the uterus to feel for the fetal bac! and small fetal parts. Use gentle but deep pressure. Using thumb and finger, grasp the lower portion of the abdomen above symphisis pubis, press in slightly and ma!e gentle movements from side to side. Facing foot part of the woman, palpate fetal head pressing downward about ' inches above the inguinal ligament. Use both hands.

Third Maneuver: To determine #awli!$s Grip engagement of presenting part.

The presenting part is notengaged if it is not movable. %t is not yet engaged if it is still movable.

Fourth Maneuver: #elvic Grip

To determine the degree of fle&ion of fetal head. To determine attitude or habitus.

Good attitude ( if brow correspond to the side )'nd maneuver* that contained the elbows and !nees. Poor atitude ( if e&amining fingers will meet an obstruction on the same side as fetal bac! )hypere&tended head* +lso palpates infant$s anteroposterior position. %f brow is very easily palpated, fetus is at posterior position )occiput pointing towards woman$s bac!*