PRE - TEST

WRITE T IF THE STATEMENT IS CORRECT AND F IF IT IS WRONG. NO ERASURES OR SUPERIMPOSITIONS PLS. ANY ERASURE OR SUPERIMPOSITION WILL BE CONSIDERED INCORRECT. USE CAPITAL LETTERS.

PRE TEST :T/F

Leopolds maneuvers are a systemic method of observation and palpation to determine fetal presentation and position. T 2. The position of the woman in leopolds maneuver is supine with knees slightly flexed. T 3. Leopolds maneuver is a four part process. - T
1.

4. Fetal presentation denotes the body part that will first contact the cervix or be born first. T 5. Fetal position is the relationship of the presenting part to a specific quadrant of a womans pelvis. T 6. The 3rd manuever determines the position of the back. F; 2nd maneuver 7. The 1st maneuver determines what part is lying above the inlet. F; 3rd maneuver

8. In doing the 3rd maneuver, the examiner faces the womans feet. F; 4th maneuver 9. In doing the 1st maneuver, palpate the fundus with one hand. F; both hands 10. In determining what part is lying the inlet, gently grasp the fundus with the thumb and fingers. F; symphisis pubis

LEOPOLDS MANEUVER

Four-part process
Determine the position of the baby in utero 2. Determine the expected presentation during labor and delivery Leopolds Maneuver is preferably performed after 24 weeks gestation when fetal outline can be already palpated. Named after Christian Gerhard Leopold, a gynecologist
1.

Preparation:
Instruct woman to empty her bladder first. Place woman in dorsal recumbent position, supine

with knees flexed to relax abdominal muscles. Place a small pillow under the head for comfort. Drape properly to maintain privacy. Explain procedure to the patient. Warms hands by rubbing together. (Cold hands can stimulate uterine contractions). Use the palm for palpation not the fingers.

Purpose First Maneuver: Fundal Grip

Procedure

Findings

To determine fetal part lying Using both hands, feel for the Head is more firm, hard and round that moves in the fundus. fetal part lying in the fundus. independently of the body. To determine presentation. Breech is less well defined that moves only in conjunction with the body. To identify location of fetal One hand is used to steady the Fetal back is smooth, hard, and resistant surface back. uterus on one side of the Knees and elbows of fetus feel with a number of angular To determine position. abdomen while the other hand nodulation moves slightly on a circular motion from top to the lower segment of the uterus to feel for the fetal back and small fetal parts. Use gentle but deep pressure. To determine engagement of Using thumb and finger, grasp The presenting part is not engaged if it is not movable. presenting part. the lower portion of the It is not yet engaged if it is still movable. abdomen above symphisis pubis, press in slightly and make gentle movements from side to side. To determine the degree of flexion of fetal head. To determine attitude or habitus. Facing foot part of the woman, Good attitude if brow correspond to the side (2nd palpate fetal head pressing maneuver) that contained the elbows and knees. downward about 2 inches Poor atitude if examining fingers will meet an above the inguinal ligament. obstruction on the same side as fetal back (hyperextended Use both hands. head) Also palpates infants anteroposterior position. If brow is very easily palpated, fetus is at posterior position (occiput pointing towards womans back)

Second Maneuver: Umbilical Grip

Third Maneuver: Pawliks Grip

Fourth Maneuver: Pelvic Grip

Leopold's maneuvers are intended to be performed by health care professionals, as they have received training and instruction in how to perform them. That said, as long as care is taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.