7/25/2019 How to Perform Leopold's Maneuver - Nursing Crib

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Leopolds Maneuver is preferably performed after 24 weeks gestation when fetal outline can be

already palpated.

Preparation:

1. Instruct woman to empty her bladder first.

2. Place woman in dorsal recumbent position, supinewith knees flexed to relax abdominal muscles. Place

a small pillow under the head for comfort.

3. Drape properly tomaintainprivacy.

4. Explain procedure to the patient.

5. Warms hands by rubbing together. (Cold hands can

stimulate uterine contractions).

6. Use the palm for palpation not the fingers.

Purpose Procedure Findings

First

Maneuver:

Fundal Grip

To determine

fetal part lying

in the

fundus.To

determine

presentation.

Using both

hands, feel for

the fetal part

lying in the

fundus.

Head is more firm, hard

and round that moves

independently of the body.

Breech is less well

defined that moves only in

conjunction with the body.

Second

Maneuver:

Umbilical

Grip

To identify

location of

fetal back.

To determine

position.

One hand is

used to steady

the uterus on

one side of the

abdomen

while the other

hand 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

Fetal back is smooth,

hard, and resistant

surface

Knees and elbows of

fetus feel with a number of

angular nodulation

http://cdn1.nursingcrib.com/wp-content/uploads/posterior-presentation.jpghttp://cdn1.nursingcrib.com/wp-content/uploads/posterior-presentation.jpghttp://cdn1.nursingcrib.com/wp-content/uploads/posterior-presentation.jpg

7/25/2019 How to Perform Leopold's Maneuver - Nursing Crib

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deep pressure.

Third

Maneuver:

Pawliks Grip

To determine

engagement of

presenting

part.

Using thumb

and finger,

grasp the

lower portion

of theabdomen

above

symphisis

pubis, press in

slightly and

make gentle

movements

from side to

side.

The presenting part

is notengaged if it is not

movable.It is not yet

engaged if it is still

movable.

Fourth

Maneuver:

Pelvic Grip

To determinethe degree of

flexion of fetal

head.To

determine

attitude or

habitus.

Facing foot

part of the

woman,

palpate fetal

head pressing

downward

about 2 inches

above the

inguinal

ligament.

Use both

hands.

Good attitude if brow

correspond to the side

(2nd maneuver) that

contained the elbows and

knees.

Poor atitude ifexamining fingers will

meet an obstruction on

the same side as fetal

back (hyperextended

head)Also palpates

infants anteroposterior

position. If brow is very

easily palpated, fetus is at

posterior position (occiput

pointing towards womans

back)