LEOPOLD’S MANEUVER
A. Attitude
1. Displays proper grooming and wears
complete well pressed uniform
2. Observes proper decorum at all times
3. Accepts constructive criticism
4. Handles mannequin/ patient with care
and support
B. Preparation
5. Explains the procedure to the patient
- I will explain the procedure, it is
called Leopold’s Manuever. It has
four grips and this is important for
us to know the fetal presentation and
fetal lie of the baby inside your
womb
6. Ask the patient to empty her bladder
- Before we proceed, you can first
urinate on our restroom so that there
will be no discomfort once we start
our assessment.
7. Positions the patient supine with knees
slightly flexed. Puts a small pillow or
rolled towel under one side
- Allow the patient to lie in a supine
position with slightly knee flex.
- Put small pillow and put in her back
so that it will not cause any supine
hypotension syndrome
8. Washes hands using warm water/ warm
hands by rubbing palms together
- To avoid any cross- contamination
of microorganisms, it is necessary to
use a warm water
- Rub hands palm to palm
9. Drapes the patient properly exposing
only the abdomen
- Allow me to remove this one and
expose only the belly or abdomen
10. Observes patient’s abdomen for the
longest diameter and where fetal
movements is apparent
- So observe muna
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C. Measuring the Fundal Height
11. Palpate the symphasis pubis
- So I will be palpating symphasis
pubis
12. Place zero point of the tape measure
from the notch above the symphysis
- Now I’ll be using my tape measure
to identify the fundic height
measurement of the baby.
- I’ll be using centimeter part.
- The zero line must be superior to the
symphysis pubis which is located
here and we’re gonna be following
the abdominal curve.
13. Palpates the fundus location and place
the end of the tape at the superior aspect
of the fundus.
14. Notes fundal height using centimeters as
unit of measurement
1ST Manuever
(Fetal Presentation)
1. Stands at the side of the patient, facing
her, place both (warm) hands flat resting
on the fundus
- We will be assessing for the
presentation of the baby or the fetal
line
- So we’re going to be assess if it’s
breech or cephalic
- You can see that it is breech if it’s
round, hard and movable but if its
round, soft and immovable it means
it’s a cephalic.
2. Palpate the fundus using the finger pads
and the palm
- I will be facing the client and start
the palpation
- I’m going to palpate right here and
observe
3. Determine consistency, shape and
mobility
- When palpating, a head feels more
firm than a breech, a head is round
and hard; the breech is less well
defined. The head moves
independently of the body; the
 breech moves only in conjuction
with the body
4. Determine fetal presentation
2nd Manuever
(Fetal back/Extremities)
1. Faces the client and slides each hand
resting on either side of the abdomen.
(Right hand at left side of mother’s
abdomen and vice versa)
- “this manuever locates the back of
the fetus
2. Palpates the sides of the uterus. Holds
left hand stationary while the right hand
palpates the opposite side of the uterus
from top to bottom; anteriorly and
posteriorly
- This method is most successful to
determine the direction the fetal
back is facing.
- One hand will feel a smooth, hard,
resistant surface (the back), while on
the opposite side, (the knee and
elbows of the fetus) will be felt.
3. Determine where the fetal back is facing
- It is important to determine the
fetal’s back to us to know where can
we auscultate the fetal’s heartbeat,
so are the fetal’s heart rate
- I will be placing my stethoscope to
determine the normal heart rate of
the baby which is 120 to 160
- One hand is used to steady the
uterus on one side of the abdomen
while the other hand moves from
top to the lower segment of the
uterus to feel for the small fetal
parts.
4. Using stethoscope, locate and count the
fetal heart tone
- I will be placing my stethoscope to
determine the normal heart rate of
the baby which is 120 to 160
3rd Manuever
(Engagement)
1. Gently grasps the lower portion of the
abdomen just above the symphysis pubis
using the thumb and the index finger.
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Tries to press the thumb & the fingers
together grasping the presenting part
- I will be forming an L shape on my
hand which is my index finger and
my thumb
- I will be placing it right above the
symphysis pubis of the patient.
- We’re going to observed the degree
of engangement
2. Attempts to move the presenting part
from side to side
3. Determines if presenting part is engaged
or floating
- If this moves when you move it
from side to side or you move it
upward to lift up the head it means
the fetus head is not engaged, but if
you move it and its immovable it
means that it is engaged
4th Manuever
(Attitude)
1. Faces the feet of the patient, dip the
three fingers of each hand on either side
of the symphysis pubis
- For the first, second and thirt
maneuver we are facing the client
but for the fourth manuever we’re
gonna facing his foot
- It determines fetal attitude and
degree of fetal extension into the
pelvis; it should be done only of the
fetus is in a cephalic presentation.
2. With one hand palpating an obstruction
locating the cephalic prominence while
the other hand sliding on the fetal nape
3. Determines fetal attitude or the degree
of flexion (Cephalic prominence is
opposite of the fetal back: well flexed
baby; If obstruction is just below the
chin anteriorly, indicates posterior
position)
- It determines fetal attitude and
degree of fetal extension into the
pelvis; it should be done only of the
fetus is in a cephalic presentation.
 - A well flexed head is right opposite
to the fetal back

After Care
1. Informs patient of the results of the
procedure.

2. Assist patient to get up from

bed/stretcher

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