LEOPOLD’S MANUEVER

FHT & FHB TAKING

MS. JOIE S. OLIVEROS RN,MN

LEARNING OUTCOMES
At the end of the pre-recorded presentation the student will be
able to:
▪ Define what is Leopold’s Maneuver
▪ Know how to measure Fundal height,
▪ Identify the different types of pelvis and fetal presentation
▪ Demonstrate Leopold’s Maneuver
▪ Determine how to take Fetal Heart Tone
Leopold’s Maneuvers
- Is a common and systematic way to
determine the position of fetus inside the
woman’s uterus; they are named after the
gynecologist Christian Gerhard Leopold
DEFINITION:
- An abdominal observation and palpation using the four
(4) manuevers of Leopold’s to provide a systematic
examination
ANATOMY OF UTERUS
 PURPOSES
1. To Determine the
presentation and
position
2. To know if more
than one fetus is
present and if it is
moving
 3. To correspond uterine
size and fundal height to
the gestational age of the
fetus
Maternal Pelvis
4. To know if the
presenting part is
engaged
 Fetal Position, the relationship of the
part of the fetus that presents in the
pelvis to the four quadrants of the
maternal pelvis, identified by initial
L (left), R (right), A (anterior), and
P (posterior). Positions (Positions
(Applicable Terms)
The presenting part is also identified
by initial O (occiput), M (mentum),
and S (sacrum).
Examples
If a fetus presents with the occiput
directed to the posterior aspect of
the mother's right side, the fetal
position is right occiput posterior
(ROP).
 Cephalic presentations are vertex, brow,
face, and chin.
 Breech presentations include frank breech,
complete breech, incomplete breech, single
or double footling breech, and shoulder
presentations
4 LEOPOLD’S MANEUVER
EQUIPMENT
NEEDED
 PROCEDURE

▪ Wash hands before performing the procedure

▪ The examiner’s hands should be warm.
▪ Identify self to the client.
▪ Explain the procedure to the client

 The woman empties her bladder before examination

▪ Provide privacy
▪ The client’s position is dorsal recumbent with one
pillow under the head.
▪ The examiner stands facing the woman on the right
if he is right handed (and vice versa if left handed).
9. Do the First Maneuver
FUNDAL GRIP
❖ Facing the mother, palpate the sites
of the uterus and fundus by
using both palms.

-The examiner palpates the superior

surface of the fundus and determines
the consistency, shape, and mobility
of palpated part.
Second Maneuver UMBILICAL GRIP
❖ Still facing the mother, the examiner’s palmar
surface of the hands will be placed on the sides of
the abdomen. To identify the location of the back
and small parts.

❖ Palpate down sides of the uterus apply gentle but

firm deep pressure in the side of fetal back, it is a
long continuous structure, smooth and firm will be
felt the side & it is important to know the location
of the fetal back which can guide you to locate an
audible fetal heart sound of the fetus,the fetal
extremities will feel nodular reflecting on the
portion of fetal extremities
3rd Maneuver
PAWLIKS GRIP
❖ Still facing the mother, this is done by
grasping the lower uterine segment
between the thumb and fingers of
one hand to feel the presenting part

❖ The examiner place one hand just

above the symphysis note whether
the palpated part feels like fetal head
or the breech and whether the
presenting part is engaged
 PELVIC GRIP
4th Maneuver
❖ Turning and facing the woman’s feet,
gently moving the fingers down the
sides of the uterus.

❖ approximately 2 inches above inguinal ligaments

and presses downward and inward in the
direction of the birth canal
 FETAL HEART TONE TAKING
1. Note location, rate and 3. Place the stethoscope on
character the abdomen over the back or
chest of the fetus, depending
which is closer to the uterine
exit.

2. Determine the position,

presentation and RLE of the
fetus by palpation.
 FETAL HEART TONE TAKING
4. Listen and count the beat  Avoid friction noises caused
for 1 minute by fingers on abdominal
area.

5. Check the rate before,  Differentiate between FHT

during and after the and other abdominal
contraction. sounds.
a. Fetal Heart Tones – very
rapid, somewhat muffled
tickling sound.
 TWO FETAL HEART SOUND
 Uterine bruit - soft  Funic Souffle – a
murmur caused by hissing sound
the passage of blood produced by passage
through the dilated of blood through the
uterine vessels, it is umbilical arteries, it is
synchronous with fetal
synchronous with
heart rate
maternal pulse.
DEMONSTRATION OF LEOPOLD’S MANEUVER
FETAL HEART
TONE TAKING
THANK YOU SO MUCH FOR
LISTENING