LEOPOLD’S MANUEVER

Definition: Leopold’s maneuver is a systematic way to determine the position of the

fetus inside the woman’s uterus.

Purpose: To determine the fetal presentation and position by systematically

palpating the gravid abdomen.

Materials: Drape

Direction: Score the following steps according to the rating scale:

3 – Excellent
2 – Satisfactory
1 – Needs Practice
0 – Not Performed

PROCEDURE RATIONALE RATING REMARKS

1. Identify the client and Explaining the procedure facilitates cooperation
explain the procedure. and helps to educate the patient about the
procedure. It also reduces anxiety.
2. Instruct the client to void or An empty bladder promotes comfort and
empty her bladder. allows for more productive palpation.
3. Position the client in a This helps the mother relax its abdominal
dorsal recumbent position. muscles to enhanced palpation.
4. Drape the client and expose This will help the nurse prepare for the first
the abdomen from the level of maneuver. Exposing the said area/ directions
the xiphoid process down to helps the nurse perform the procedure at ease.
the symphysis pubis.
5. Warm the hands by rubbing To prevent tensing of abdominal muscles.
each other.
6. Position yourself at the side This is crucial as it help to perform the procedure
of the bed, facing the client. accurately.
7. First Maneuver: This helps to determine the presentation and the
With both hands, palpate fetal area lying in the fundus. A head feels more
upper abdomen and fundus firm than a breech is round and hard, and moves
for: consistency (head is independently of the body. Proper positioning of
round and hard, breech is well hands provides accurate findings.
defined); mobility (head
moves independently, breech
less mobile). The buttocks
feels softer, is symmetric and
has small bony prominences;
it moves with the trunk.
8. Second Maneuver: This maneuver locates the back of the fetus.
Move both hands down; The fetal back feels like a smooth, hard, and
palpate the sides of the resistant surface; the knees and elbows of
abdomen with gentle but deep the fetus on the opposite side feel more like
pressure using the tips of his
a number bumps or nodules.
or her hands. Backside-
smooth, hard, resistant
surface; while Extremities,
knees and elbows have
angular modulations).
9. Third Maneuver: This maneuver determines which part of the
First grasp the lower portion of fetus is at the inlet and its mobility. If the
the abdomen just above the presenting part moves upward so your
symphysis pubis with the fingers and thumb can be pressed together,
thumb and fingers of the right.
the presenting part is not engaged. If the firm
Assess whether the
presenting part is engaged in
part is felt, it is the head; if soft it is the
the pelvis (if head is engaged, breech.
it will not move. If it is soft, it is
the back).
10. Position yourself at the This is to prepare for the right position for the
side of the bed, facing towards fourth maneuver.
the client’s feet.
11. Fourth Maneuver: This maneuver is only done if the fetus is in a
The fingers of both hands are cephalic presentation because it determines fetal
moved gently down the sides attitude and degree of fetal extension into the
of the uterus towards the pelvis.
pubis. The side where there is
resistance to the descent of
the fingers toward the pubis is
greatest is where the brow is
located. If the head of the
fetus is well-flexed, it should
be on the opposite side from
the fetal back. If the fetal head
is extended though,
the occiput is instead felt and
is located on the same side as
the back.
12. Reposition the client. This helps the client to feel comfortable.
13. Record/chart any This may be used for future references.
abnormal observation and
findings on the mother and
baby.
TOTAL SCORE
39

INSTRUCTOR : __________________________ AVERAGE: __________________

DATE : __________________________