Leopold’s maneuver

Leopold’s maneuver is a systematic method of observation and palpation to determine fetal

presentation and position and are done as part of a physical examination. It is performed after
24 weeks of gestation.

4 systematic steps in palpating the uterus

1. Fundal grip
 This maneuver determines whether the fetal
head or breech is in the fundus. A head feels
more firm than than a breech, is round and
hard, and moves independently of the body;
the breech feels softer and moves only in
conjunction with the body

2. Umbilical grip
 this maneuver locates the back of the fetus.
The fetal back feels like a smooth, hard, and
resistant surface; the knees and elbows feel
more like a number of angular bumps or
nodules.

3. Pawlick’s grip
 This maneuver determines which part of the
fetus is at the inlet and its mobility. If the
presenting part moves upward so your
fingers and thumb can be pressed together,
the presenting part is not engaged (not
firmly settled into the pelvis). If the part is
firm, it is the head; if soft, then it is breech

4. Pelvic grip
 This maneuver is only done if the fetus is in
cephalic presentation because it determines
fetal attitude and degree of fetal extension
into the pelvis. The fingers of one hand will
slide along the uterine contour and meet no
obstruction, indicating the back of the fetal
neck. The other hand will meet an inch or so
above the ligament—this is the fetal brow.
The position of the fetal brow should
correspond to the side of the uterus that
contained the elbows and knees of the fetus.
if the fetus is in a poor attitude, the
examining finger will meet an obstruction
on the same
side as the fetal back; that is, the finger s will
touch the hyperextended head. If the brow
is very easily palpated, the fetus is probably
in a posterior position