Leopold Maneuver – Step by Step Guide To Perform Leopold Maneuver

Leopold Maneuver is an important procedure, that every nurse should be well versed with.

Definition of Leopold maneuvers –

It is a commonly used procedure to know the position of a fetus inside the uterus. It will also help to find out the presentation and engagement of fetus

Why it called as Leopold’s maneuver

Because it is established by a German based great gynecologist Christian Gerhard Leopold. The great gynecologist Leopold lived from 1846 to 1911

Importance of Leopold’s maneuver

1. To know and identify the fetal parts inside the uterus for fetal lie and presenting parts

2.Evaluation and palpation of fetal back to know the fetal presentation

3.Determination and identification of which fetal part come over the symphysis to know the fetal attitude

4. Identification of fetal head prominence for direction and degree of flexion of head

5. Perfect assessment and palpation may determine whether delivery going to normal or it will require cesarean section

Performing the Leopold’s maneuver

1. The women on whom the procedure we are going to perform should lie on her back with knees drawn up a little.

2 . She should be with empty bladder if not, request her to empty the bladder first.

3. Uncover the abdomen and start procedure

Procedure in detail

1 fundal grip

First Leopold Maneuver Fundal GripThe first maneuver is also known as fundal grip. Palpate the upper abdomen of women in lie down position. During palpation, the both hands should be in cupping position and able to grip and Palpate the upper part of the abdomen in order to know which fetal part you can able feel there.
Generally you will be going to find the buttocks, which feel soft but sometimes you may feel hard & if it feels hard then think of the head of fetus. Because head feels firm round and hard.

2. Lateral grip

Second Leopold Maneuver Lateral GripThe second maneuver is also known as lateral grip, this process is done to identify the location of a fetal back. As the name suggest, palpate on a lateral side of the abdomen using the palm of hands. Generally fetal back will feel like firm and smooth while fetal extremities like arms & legs will feel like nodules and small irregularities. This helps in findings of position of fetus

3. Pawlick’s grip

Third Leopold Maneuver Pawlicks GripThis third maneuver is also known as Pawlick’s grip. In this procedure; Palpate the lower part of the abdomen which is just above the symphysis portion. Hold the lower part of the abdomen between an index finger and thumb. After that press inward and feel the movement
If there is head of a fetus in presentation, then go for the determination of head attitude

4. Pelvic grip

Fourth Leopold Maneuver Pelvic GripThis procedure is also known as a pelvic grip. Palpation of the pelvis is done in this process
During this process, examiner should stand in such a way that he/she should face the women’s feet
Palpate both the side of the pelvic region to determine head prominence. If the head of a fetus is flexed, that means it is opposite side of fetal back and if the head of the fetus is extended then it same side of the fetal back.

Precautions –

1. During this process take care of pressure you put on mothers abdomen. Your palpation pressure should not disturb the fetus.

2. It may difficult to understand in case of fatty women

3. It should be done under train examiner

4. It is truly diagnostic procedure it may require ultrasonography to understand the subtle details of the fetus.

 

Images Source – about.com (Pregnancy Section)

About the author

Dr. Narendra

Narendra is a practicing doctor from India and has a passion for teaching. He loves to write and help others to understand the subject better with his influencing communication skill.

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