Leopolds’ maneuver

1. LEOPOLDS’ MANEUVERLEOPOLDS’ MANEUVER

2. At the end of the lecture, the
students will be able to:
–Identify the steps in performing
Leopolds’ Maneuver.
–Identify Nursing considerations in
performing Leopolds’ maneuver.

3. •are a common and systematic way
to determine the position of a fetus
inside the woman's uterus.
•are important because they help
determine the position and presentation of
the fetus.
•Named after the gynecologist
Christian Gerhard Leopold.

4. •Maneuver is preferably performed after
24 weeks gestation when fetal outline
can be already palpated.
•The maneuvers are not truly diagnostic.
•Actual position can only be determined
by ultrasound performed by a
competent technician or professional.

5. •Difficult to perform in obese
women.
•Women with hydramios.
•Women with full bladder.

6. Nursing Considerations
•Instruct woman to empty her bladder first.
•Place woman in dorsal recumbent position,
supine with knees slightly flexed. Place a
small pillow under the head for comfort.
•Drape properly to maintain privacy.
•Explain procedure to the patient.
•Warm hands by rubbing together.
•Use the palm for palpation not the fingers.

7. •While facing the
woman, palpate the
woman's upper
abdomen with both
hands.
•Often determine the
size, consistency,
shape, and mobility of
the form that is felt.
•The fetal head is
hard, firm, round, and
moves independently
of the trunk.
•The buttocks feels
softer, is symmetric,
and has small bony
prominences; it
moves with the trunk.

8. What lies at the fundus?What lies at the fundus?

9. •The maneuver attempts
to determine the
location of the fetal
back.
•Facing the woman, the
health care provider
palpates each side of
the abdomen with
gentle but deep
pressure using the tips
of his or her hands.
•The fetal back is firm
and smooth, hard,
resistant surface.
•Fetal extremities feels
like small irregularities
and protrusions.

10. Where is the fetal back?Where is the fetal back?

11. •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 with the thumb
and fingers of the
right hand.

12. What is in the inlet?What is in the inlet?

13. •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.
•The fingers of both hands are moved
gently down the sides of the uterus
towards the pubis.

14. What is the attitude?

15. •Good attitude
–If brow
correspond to
the side that
contained the
elbows and
knees.

16. •Poor attitude
–If examining
fingers will meet
an obstruction
on the same side
as fetal back.

17. Thank you
all !!!