Leopold’s Maneuver

Leopold’s Maneuver

-common and systematic ways to determine the position of the fetus inside the woman’s

uterus.

-this maneuver is named after the gynecologist- Christian Gerhard Leopold

-this are absorbed to estimate term fetal height.

PURPOSE: to systematically observe and palpate the abdomen to determine fetal

presentation and position.

FOUR DISTINCT ACTION/MANEUVER

1. First Maneuver: Fundal grip- stand at the foot of the woman, facing her and place

both hands flat on her abdomen. Palpate the superior surface of the fundus.

Determine consistency, shape and motility.

Fetal head- hard, round an moves independently.

Buttocks- feels softer and symmetric.

Shoulder and limbs- have small bony processes.

2. Second Maneuver: Umbilical Grip- face the woman, hold the left hand stationary

on the left side of the uterus while you palpate with the right hand on the opposite side

of the uterus from the top of the bottom. Repeat the palpation on the opposite side.

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3. Third Maneuver: 1st Pelvic grip- gently grasp the lower portion of the abdomen just

above the symphysis pubis between the thumb and the finger together. Determine any

movement and whether the part feels firm or soft. If not actively engaged in birthing

process it may be gently push back and forth. If engaged, it should not be movable.

4. Fourth Maneuver: 2nd Pelvic grip- place fingers on both sides of the uterus

approximately 2 inches above the inguinal ligament pressing downward and inward in

the direction of the birth canal. Allow fingers to be carried downward.

Well Flexed- it should be on the opposite side if the fetal back

Extended- occiput is on the same side of the fetal back

FUNDAL HEIGHT OR UTERINE HEIGHT

By the end of 12 weeks of uterus, can be firm as globe under the abdominal wall just

above the pubic symphysis.

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20-22 weeks riches the level of umbilicus.

36 weeks usually touches the xiphoid- DOB. NPO- Nothing per orem, if the stomach

is full it presses the diaphragm – DOB about 38 weeks before term.

LEOPOLD’S MANEUVER

PROCEDURE

1. Introduce yourself to the patient and explain the procedure.

2. Instruct the woman to empty her bladder.

3. Wash your hands and provide privacy.

4. Position the woman supine with knees flexed. Place a small pillow or rolled tower

under her left side.

5. Rub both hands together before doing the first maneuver.

6. First Maneuver: stand at the foot of the woman, facing her, and place both hands

flat on her abdomen. Palpate the superior surface of the fundus. Determine

consistency, shape and mobility.

7. Second Maneuver: face the woman, hold the left hand stationary on the left side of

the uterus while you palpate with the right hand on the opposite side of the uterus

from the top to bottom. Repeat palpation on the opposite side.

8. Third maneuver: gently grasp the lower portion of the abdomen just above the

symphysis pubis between the thumb and the fingers together. Determine any

movement and whether the part feels firm or soft.

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Leopold’s Maneuver

9. Fourth Maneuver: place fingers on both sides of the uterus approximately 2 inches

above the inguinal ligaments, pressing downward and inward in the direction of the

birth canal. Allow fingers to be carried downward.

10. Return the patient to comfortable position.

11. Proper documentation. (Position. Presentation and reaction of the mother to the

procedure)