LEOPOLD’S MANEUVER

DEFINITION
 It is a systematic abdominal palpation to determine the position and
presentation of to the fetus. It is done at about 32 weeks and over.
PURPOSE
 To identify fetal presentation, the presenting part lie, altitude and degree of
descent.
 To estimate the size and number of fetus.
EQUIPMENT
 Drape

PROCEDURE RATIONALE
1. Identify the client and explain the  Knowing the client to prevent error.
procedure.  Giving information allays fear and anxiety
thus gaining maternal cooperation.
2. Instruct the client to empty or void her  To promote comfort on the part of the
bladder. client.
3. Position the client in dorsal recumbent.  Proper positioning relaxes both mother and
baby. It also facilitates the easy location,
presentation and lie of the fetus.
4. Drape the client and expose the  To provide privacy.
abdomen from the level of the xyphoid
process down to the symphysis pubis.
5. Warm two hands by rubbing one  The use of warm hands during the
against the other before placing them palpation prevents tension and hardening
on the abdomen. of the abdominal muscles favouring good
results.
6. Perform the four maneuvers. During the  The position favors accurate performance
first three maneuvers, the examiner of the maneuvers.
stands at the side of the (client) bed
and faces the clients.
FIRST MANEUVER  To determine the fetal part lying in the
A. With both hands, palpate upper fundus.
abdomen and fundus for:
Consistency-head is
round,hard,breech is well defined.
Mobility- head moves independently,
breech less mobile

SECOND MANEUVER  To determine the fetal back for fetal heart

A. With both hands moving down; tone, usually found in the left lower
Palpate the sides of the uterus from quadrant.
the top to bottom.
1. One side- smooth, hand, resistant
surface(back).
Other side-angular
modulation(knees and elbows)
THIRD MANEUVER  To determine engagement of the
A. With the right hand over the presenting part.
 symphysis, identify the presenting
part by grasping the lower abdomen
with thumb and fingers.
Assess whether the presenting part is
engaged in the pelvis (if head is
engaged, it will not move. If it is soft,
it is the back).
FOURTH MANEUVER  To determine the degree of flexion of the
The nurse alters position by tuning fetal head.
toward the patient’s feet, with both hands;
assess the descent of the presenting part by
locating the cephalic prominence of brow.
A. Place your finger on both sides of
uterus, about two inches above
inguinal ligament. Press downwards
and inward.
B. If the fetal back is palpated, it meets
no obstruction.
C. The other hand will meet obstruction,
the fetal brow is palpated.
7. Reposition the client.  To make the client fee; comfortable.
NAME DATE PERFORMED
COURSE/YR & SEC

CHECKLIST ON LEOPOLD’S MANEUVER

PROCEDURE 5 4 3 2 1
1. Assess the physical condition of the mother and baby.
2. Determine the nursing needs of the mother and baby.
3. Wash hands.
4. Prepare the client for the procedure.
5. Identify the client.
6. Explain the procedure.
7. Instruct the patient/client to void or empty bladder.
8. Assist client to and position in dorsal recumbent.
9. Drape client to provide privacy.
10. Expose the abdomen from the level of xyphoid process down to
symphysis pubis.
11. Perform the four steps in leopold’s maneuver by palpating the
abdomen.
a. Palpate the upper abdomen and fundus
b. Palpate the sides of the uterus from top to bottom.
c. Grasp lower portion of the abdomen with thumb and
fingers.
d. Press downward about 2 inches above the inguinal
ligament with both hands.
12. Reposition the client.
13.Observe/evaluate the client’s presentation and position of the
fetus inside the uterus of the mother.
14. Record/chart any abnormal observation and findings on the
mother and baby.

Remarks:_________________________________________________________________
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Equivalent Grade: ______

Rating Scale:

Excellent : 96 – 100%
Very Satisfactory : 90 – 95%
Very Good : 85 – 89%
Good : 80 – 84%
Fair : 75 – 79%
Poor : 74 & below

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Clinical Instructor Student’s Signature