Leopold ’ s Manaeuver

JEFFREY A . LUCERO , S . L .
III Bachelor of Science in Nursing
Cavite State University, Indang, Cavite
Contents
Definition
Preparatory Procedures
Manaeuvers
üFirst Manaeuver
üSecond Manaeuver
üThird Manaeuver
üFourth Manauver
Definition
a common and systematic way to
determine the position of a fetus inside
the woman's uterus
named after the gynecologist Christian
Gerhard Leopold
also used to estimate term fetal weight
Preparatory
Procedures

1. Instruct woman
to empty her
bladder first.
Rationale:



The full bladder
may be mistakenly a
part of the fetus.
2.

Place woman in dorsal
recumbent position, supine
with knees flexed to relax
abdominal muscles. Place a
small pillow under the head
for comfort.
Rationale:



This easily exposes
the body part to be
examined.


3. Drape the client
properly.
Rationale:



This promotes
privacy.

4.

Explain procedure to
the patient.
Rationale:



This make the client
knowledgeable and
establishes rapport between
the her and the nurse.

5.

Warm hands by rubbing
together.
Rationale:



Cold hands can stimulate
uterine contractions.
6.

Use the palm for
palpation not the
fingers.
Rationale:



Doing so clearly verifies
the accuracy of the
procedure.
Manaeuvers
First manaeuver:Fundal Grip
Purpose:
1.To determine fetal part lying in the fundus.
2.To determine presentation.


 Procedure:

Using both hands, feel for the fetal
part lying in the fundus.



First manaeuver:Fundal Grip

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.

Findings…
Second manaeuver:Umbilical Grip
Purpose:
1.To identify location of fetal back.
2.To determine position.


 Procedure:

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 deep pressure.

Second manaeuver:Umbilical Grip


Fetal back is smooth, hard, and resistant

surface


Knees and elbows of fetus feel with a

number of angular nodulation

Findings…
Third manaeuver:Pawlik’s Grip
Purpose:
1.To determine engagement of presenting part.


 Procedure:

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.
Third manaeuver:Pawlik’s Grip


The presenting part is not engaged if it is

not movable.


It is not yet engaged if it is still movable.

Findings…
Fourth manaeuver:Pelvic Grip
Purpose:
1.To determine the degree of flexion of fetal
head.
2.To determine attitude or habitus.
 Procedure:

Facing foot part of the woman, palpate
fetal head pressing downward about 2
inches above the inguinal ligament.
Use both hands.
Fourth manaeuver:Pelvic Grip


Good attitude – if brow correspond to the

side (2nd manaeuver) that contained the
elbows and knees.


Poor atitude – if examining fingers will meet

an obstruction on the same side as fetal
back (hyperextended head) Also palpates
infant’s anteroposterior position. If brow is
very easily palpated, fetus is at posterior
position (occiput pointing towards woman’s
back)

Findings…
That’s all for
Leopold’s Manaeuver..

…some questions?