Leopold’s Maneuver

Leopold’s Maneuver

                Purpose: is done to determine the attitude, fetal presentation lie, presenting part, degree of descent, an estimate of the size, and number of fetuses, position, fetal back & fetal heart tone

- use palm! Warm palm.

Prep mom:

1.       Empty bladder

2.       Position of mom-supine with knee flex (dorsal recumbent – to relax abdominal muscles)

Procedure:

1^st maneuver: place patient in supine position with knees slightly flexed; put towel under head and right hip; with both hands palpate upper abdomen and fundus. Assess size, shape, movement and firmness of the part to determine presentation

2^nd Maneuver: with both hands moving down, identify the back of the fetus ( to hear fetal heart sound) where the ball of the stethoscope is placed to determine FHT. Get V/S(before 2^nd maneuver) PR to diff fundic soufflé (FHR) & uterine soufflé.

Uterine soufflé – maternal H rate

3^rd Maneuver: using the  right hand, grasp the symphis pubis part using thumb and fingers.

To determine degree of engagement.

Assess whether the presenting part is engaged in the pelvis )Alert : if the head is engaged it will not be movable).

4^th Maneuver: the Examiner changes the position by facing the patient’s feet. With two hands, assess the descent of the presenting part by locating the cephalic prominence or brow. To determine attitude – relationship of fetus to 1 another.

When the brow is on the same side as the back, the head is extended. When the brow is on the same side as the small parts, the head will be flexed and vertex presenting.

Attitude – relationship of fetus to a part – or degree of flexion

Full flexion – when the chin touches the chest