LEOPOLDS MANEUVER PURPOSES: a.

To determine the following: Presentation ( Cephalic, Breech, Shoulder) Lie (Longitudinal, Transverse, Oblique) Attitude ( Complete/Full Flexion, Partial Flexion, Partial Extension, Complete/ Full Extension) Engagement ( Floating, Engage) PROCEDURE Preparation Explain the purpose (why such procedure is necessary). Ask the mother to empty her bladder Position the mother in dorsal recumbent. Provide privacy Warm hands and apply them to the abdomen. First Maneuver (Fundal Grip) Stand to the patients right side facing her head Keeping the fingers of your hands together, palpate the uterine fundus. Determine which fetal part presents at the fundus. Second Maneuver (Umbilical Grip) Move both hands to the sides of the uterus. Keep your left hand steady and palpate the patients abdomen with your right hand. Determine the positions of the fetus; back and small parts. Keep your right hand steady and palpate the patients abdomen with your left hand. Third Maneuver (Pawliks Grip) Place your right hand above the symphysis pubis with your thumb on 3 2 1 0 REMARKS

one side of the fetus presenting part and your fingers on the other side. Gently palpate the fetus presenting part. Determine whether the buttocks or the head is the presenting part in the pelvis. ( this should confirm the findings of the first maneuver) Fourth Maneuver (Pelvic Grip) Change your position so you are facing the patients feet. Place your fingers of both hands on each side of the uterus above the symphysis pubis and attempt to palpate the cephalic prominence (forehead).
Sources: Introduction to Health Assessment and Physical Examination, Mary Ellen Zator, pp 905-906 Maternal and Child Nursing, Adelle Pillitteri, pp515-516

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