Leopold’s maneuver

1. Instruct woman to empty her bladder first.

2. Place woman in dorsal recumbent position, supine with knees flexed to relax abdominal muscles. 3.Place a small
pillow under the head for comfort.
4 . Drape properly to maintain privacy.
5. Explain procedure to the patient.
6. Warms hands by rubbing together. (Cold hands can stimulate uterine contractions).
7. Use the palm for palpation not the fingers.
steps Purpose Procedure Findings
1. First Maneuver: To determine fetal part Using both hands, feel Head is more firm, hard
Fundal Grip lying in the fundus. To for the fetal part lying in and round that moves
determine presentation. the fundus. independently of the
body. Breech is less well
defined that moves only
in conjunction with the
body.

2. Second Maneuver: To identify location of One hand is used to Fetal back is smooth,
Umbilical Grip fetal back. To determine steady the uterus on one hard, and resistant
position. side of the abdomen surface Knees and
while the other hand elbows of fetus feel with
moves slightly on a a number of angular
circular motion from top nodulation
to the lower segment of
the uterus to feel for the
fetal back and small fetal
parts. Use gentle but
deep pressure.

Third Maneuver: To determine Using thumb and finger, The presenting part is not
Pawlik’s Grip engagement of grasp the lower portion engaged if it is not
presenting part. of the abdomen above movable. It is not yet
symphisis pubis, press in engaged if it is still
slightly and make gentle movable
movements from side to
side.

Fourth Maneuver: To determine the degree Facing foot part of the Good attitude – if brow
Pelvic Grip of flexion of fetal head. woman, palpate fetal correspond to the side
To determine attitude or head pressing downward (2nd maneuver) that
habitus about 2 inches above the contained the elbows
inguinal ligament. Use and knees. Poor atitude –
both hands if examining fingers will
meet an obstruction on
the same side as fetal
back (hyperextended
head)Also palpates
infant’s anteroposterior
position. If brow is very
easily palpated, fetus is
at posterior position
(occiput pointing towards
woman’s back)