Leopold’s Maneuver

In obstetrics, Leopold maneuvers are a common and systematic way to determine the position of a fetus inside the woman's uterus; they are named after the gynecologist Christian Gerhard Leopold. They are also used to estimate term fetal weight.
The aim of Leopold maneuvers is to determine the fetal presentation and position by systematically palpating the gravid abdomen.
ctto Marie Belen Tamayor - Leopold's Maneuver, Miss Marie's presentation provided the slides that explain Leopold's maneuver.

1. LEOPOLD’S MANEUVER By : Chrisly Bautista Juvelyn Damuag

2. The Leopold maneuvers, named after the German obstetrician and gynecologist Christian Gerhard Leopold (1846–1911), are part of the physical examination of pregnant women.

3. Why is it performed? The aim of Leopold maneuvers is  to determine the fetal presentation and position by systematically palpating the gravid abdomen , as well as estimate your baby's weight .

4. This process allows medical professionals to not only make a birth weight estimate but also address any underlying problems that may occur down the road. This will help you and your provider be better prepared for your labor and determine if it might be safer to perform

5. They're also low-cost , non-invasive , and don't require the use of expensive equipment such as an  ultrasound . Plus they tell your provider how ready your baby is for birth so they can better prepare for your labor.

6. Leopold’s preferably performed after 24 weeks of gestation (about 6 months). [ Maneuver’s are not truly diagnostic A ctual position can only be determined by ultrasound performed by a competent professional. ]

7. Factors Affecting Difficult to perform in obese women. Women with hydramnios Women with full bladder.

8. What are the 4 maneuver? First maneuver: fundal grip. Second maneuver: lateral grip. Third maneuver: second pelvic grip or Pawlik's grip. Fourth maneuver: Leopold's first pelvic grip.

9. Nursing Considerations Instruct the women to empty her bladder Wash hands (then dry) Provide privacy Verify the client Explain procedure Place woman in dorsal recumbent position.

10. Nursing Considerations Warm hands by rubbing together Use the palm for palpation not the fingers.

11. FIRST MANEUVER: FUNDAL GRIP What lies in the fundus? While facing the woman, palpate the upper part abdomen with both hands Often determine the size, consistency, shape and mobility of the form that is felt.

12. FIRST MANEUVER: The fetal head is hard, firm, round and moves independently of the trunk. While the buttocks, feel softer. It’s symmetric and has small bony prominences; it moves w/ the trunk.

13. SECOND MANEUVER: LATERAL GRIP Where is the fetal back? Facing the woman, the health care provider palpates each side of the abdomen with gentle but deep pressure using the tip of his/her hands.

14. SECOND MANEUVER: The fetal back is firm and smooth, hard, resistant surface. Fetal extremeties feels like small irregularities and protrusions.

15. THIRD MANEUVER: PAWLIK’S GRIP What is in the inlet? To determine what fetal part is lying above the inlet or lower abdomen. The individual performing the maneuver, first grasps the lower portion of the abdomen just above the symphysis pubis w/ the thumb and fingers of the right hand

16. FOURTH MANEUVER: PELVIC GRIP What is the attitude? The health care provider faces the woman’s feet, as he or she will attempt to locate the fetus’ brow. To determine the degree of flexion of the fetal head

17. FOURTH MANEUVER: The fingers of both hands are moved gently down the sides of the uterus towards the pubis

18. ATTITUDE describes the position of the parts of your baby's body . The normal fetal attitude is commonly called the fetal position. The head is tucked down to the chest. The arms and legs are drawn in towards the center of the chest . Good attitude – if brow correspond to the side that contained the elbows and knees Poor attitude – If examining, fingers will meet obstruction on the same side as fetal back

19. IDEAL POSITION At the beginning of your pregnancy, your baby will move around your womb freely, but towards the end, they should get into a certain position. Before birth, your baby should be head-down, facing your back, with its chin tucked to its chest so that its head is ready to enter the pelvis. This is called the cephalic presentation and it is the ideal position for delivery. Most babies will settle into this position between the 32nd and 36th week of your pregnancy. This position makes labor less complicated. Around 96% of babies will be born in the cephalic position.

20. Abnormal Position & Presentations Cephalic Posterior Position This position is also known as an occiput position or it's sometimes nicknamed "sunny-side-up." It means that your baby is positioned head down, but they're facing out instead of towards your spine. This position could increase your chances of a painful and prolonged delivery.

21. Abnormal Position & Presentations Breech Position A breech position means that your baby's bottom is facing downwards. There are three different breech positions: Frank breech:  The baby's legs are up with feet near the head Footling breech:  One or both legs is lowered in the cervix Complete breech:  The baby's bottom is first and its knees are bent Any of these positions can make for a riskier delivery so you are at risk of a C-section delivery if the baby doesn't change position before labor.

22. Abnormal Position & Presentations Transverse Lie Your baby might also be in a transverse lie position at the end of the third trimester, which means they are lying sideways across your uterus instead of vertically. If they don't change position, it could make for dangerous labor, so a C-section will be required.

23. Other presentations In  face presentation , the neck arches back so that the face presents first. In  brow presentation , the neck is moderately arched so that the brow presents first.