LEOPOLD’S MANEUVER.pptx

8/14/2019 LEOPOLDS MANEUVER.pptx

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PRE - TESTWRITE 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.


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PRETEST :T/F1. Leopolds maneuvers are a systemic method of

observation and palpation to determine fetalpresentation and position. T

2. The position of the woman in leopoldsmaneuver issupine with knees slightly flexed. T

3. Leopolds maneuver is a four part process. - T


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4. Fetal presentation denotes the body part that will firstcontact the cervix or be born first. T

5. Fetal position is the relationship of the presenting partto a specific quadrant of a womans pelvis. T

6. The 3rdmanuever determines the position of the back.F; 2ndmaneuver

7. The 1st

maneuver determines what part is lyingabove the inlet. F; 3rdmaneuver


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LEOPOLDS MANEUVER Four-part process

1. Determine the position of the baby in utero2. Determine the expected presentation during labor

and delivery

Leopolds Maneuver is preferably performed after 24

weeks gestation when fetal outline can be alreadypalpated.

Named after Christian Gerhard Leopold, agynecologist


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Preparation: Instruct woman to empty her bladder first.

Place woman in dorsal recumbent position, supinewith knees flexed to relax abdominal muscles. Place asmall pillow under the head for comfort.

Drape properly to maintain privacy.

Explain procedure to the patient.

Warms hands by rubbing together. (Cold hands canstimulate uterine contractions).

Use the palm for palpation not the fingers.


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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.

Breechis less well defined that moves only in conjunction

with the body.

Second Maneuver:

Umbilical Grip

To identify locationof fetal

back.To determine position.

One hand is used to steady the

uterus on one side of theabdomen 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 deep pressure.

Fetal backis smooth, hard, and resistant surface

Knees and elbowsof fetus feel with a number of angularnodulation

Third Maneuver:

PawliksGrip

To determine engagement of

presenting part.

Using thumb and finger, grasp

the lower portion of the

abdomen above symphisis

pubis, press in slightly and

make gentle movements from

side to side.

The presenting part is not engaged if it is not movable.

It is not yet engaged if it is still movable.

Fourth Maneuver:

Pelvic Grip

To determine the 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 attitudeif brow correspond to the side (2nd

maneuver) that contained the elbows and knees.

Poor atitudeif examining 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)


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Leopold's maneuvers are intended to be

performed by health care professionals, asthey have received training and instruction inhow to perform them. That said, as long as

care is taken not to roughly or excessivelydisturb the fetus, there is no real reason itcannot be performed at home as aninformational exercise. It is important to notethat all findings are not truly diagnostic, andas such ultrasound is required to conclusivelydetermine the fetal position.

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LEOPOLD’S MANEUVER.pptx