Leopold's Maneuvers
Leopold's Maneuvers
Leopold's Maneuvers
It is a standard palpation of the abdomen for assessing the fetal position, presentation and degree of descent.
Purposes
To determine the number of fetuses. To identify the presentation, position, degree of descent, and attitude of the fetus. To identify the point of maximum intensity of the fetal heart tone in relation to the womans abdomen.
Materials
Stethoscope Doppler
Procedure
Wash hands.
:To deter the spread of microorganisms
Let the patient empty her bladder deviate before the procedure. Position the patient on supine with one pillow under her head and with knees slightly flexed.
: To facilitate accurate assessment providing
If right handed, stand at womans right facing the patient. First Maneuver: Face the patient and palpate the uterine fundus to determine what part of the fetus lies in the upper part of the fundus.
Second Maneuver: Palpate in a downward direction on the sides of the abdomen applying gentle but deep pressure to determine the position of the fetal extremities, fetal back and anterior shoulders.
:On side of fetal back, a long
Third Maneuver: Place one hand over the symphisis pubis and grasp the lower uterine segment between the thumb and fingers to feel the presenting part.
: If engagement has occured, fetal
part feels fixed in the pelvis. The head is at inlet or in pelvis, if the presenting part is still movable, it is not engaged.
Fourth Maneuver: Turn and face the womans feet to confirm the findings of the third maneuver and determine the flexion of the fetus head into the pelvis.
:The cephalic prominence is felt on
Locate again the back of the fetus and place the stethoscope over it and listen to the fetal heart tone fo one full minute.
:Normal FHT is 120-160 beats per minute.
Note the location, rate and character of the FHT Make the patient comfortable Document the observation made; fetal findings, presentation, position, attitude and whether engaged or floating.