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    Leopold's Maneuver

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    Arlene Cerdeña Salceda
    This document describes Leopold's maneuver, which is used to determine fetal presentation, position, and engagement through abdominal palpation after 24 weeks of gestation. It involves four specific palpation techniques: 1) fundal grip to locate the fetal position, 2) umbilical grip to identify the fetal back and determine position, 3) Pawlick's grip to check for engagement of the presenting part, and 4) pelvic grip to determine fetal attitude and degree of descent into the pelvis. The findings of each maneuver are also outlined.

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    Leopold's Maneuver

    Uploaded by

    Arlene Cerdeña Salceda
    3K views22 pages
    This document describes Leopold's maneuver, which is used to determine fetal presentation, position, and engagement through abdominal palpation after 24 weeks of gestation. It involves four specific palpation techniques: 1) fundal grip to locate the fetal position, 2) umbilical grip to identify the fetal back and determine position, 3) Pawlick's grip to check for engagement of the presenting part, and 4) pelvic grip to determine fetal attitude and degree of descent into the pelvis. The findings of each maneuver are also outlined.

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    This document describes Leopold's maneuver, which is used to determine fetal presentation, position, and engagement through abdominal palpation after 24 weeks of gestation. It involves four specific palpation techniques: 1) fundal grip to locate the fetal position, 2) umbilical grip to identify the fetal back and determine position, 3) Pawlick's grip to check for engagement of the presenting part, and 4) pelvic grip to determine fetal attitude and degree of descent into the pelvis. The findings of each maneuver are also outlined.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT or read online from Scribd
    Download as ppt
    3K views22 pages

    Leopold's Maneuver

    Uploaded by

    Arlene Cerdeña Salceda
    This document describes Leopold's maneuver, which is used to determine fetal presentation, position, and engagement through abdominal palpation after 24 weeks of gestation. It involves four specific palpation techniques: 1) fundal grip to locate the fetal position, 2) umbilical grip to identify the fetal back and determine position, 3) Pawlick's grip to check for engagement of the presenting part, and 4) pelvic grip to determine fetal attitude and degree of descent into the pelvis. The findings of each maneuver are also outlined.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT or read online from Scribd
    Download as ppt
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    LEOPOLD’S MANEUVER

    LEOPOLD’S MANEUVER
     Aresystematic method of observation
    and palpation of abdomen to determine
    fetal presentation, position and
    engagement.

     Leopold’sManeuver is preferably
    performed after 24 weeks gestation when
    fetal outline can be already palpated.
    COTRAINDICATIONS: Leopold’s
    maneuver
    FETAL ATTITUDE
     Describes the degree of flexion a fetus assumes
    during labor or the relation of the fetal parts to
    each other.

     TYPES:
    1. Full or complete flexion (vertex) good attitude
    2. Moderate flexion (sinciput) military attitude
    3. Partial extension (brow)
    4. Complete extension (face) poor flexion
    FETAL LIE

     Is the relationship between the long (cephalocaudal)


    axis of the fetal body and the long ( cephalocaudal)
    axis of a woman’s body; in other words, whether the
    fetus is lying in a horizontal ( transverse) or a vertical
    (longitudinal) position.
    FETAL PRESENTATION

     Denotes the body part that will first


    contact the cervix or deliver first

     TYPES:

    1. Cephalic presentation
    2. Breech presentation

    3. Shoulder presentation
    CEPHALIC PRESENTATION:
     Types

    1. Vertex
    2. Brow
    3. Face
    4. Chin (mentum)
    BREECH PRESENTATION
     Types

    1. Complete
    2. Frank
    3. Footling
    TRANSVERSE LIE/SHOULDER
    PRESENTATION
     Types

    1. Shoulder
    2. Iliac crest
    3. Hand
    4. Elbow

    Note: Must be born in cesarean delivery


    FETAL POSITION

     isthe relationship of the presenting part to a


    specific quadrant of the woman’s pelvis.

    4 landmarks:
    1.vertex-occiput (O)
    2.face-chin/mentum (M)
    3. breech-sacrum (Sa)
    4. shoulder-scapula/acromion process (A)
    FETAL ENGAGEMENT

     Settlingof the fetal head into the pelvis


     Descent of the presenting part of the
    fetus midpoint of the pelvis
    SPECIAL CONSIDERATION
    Preparation:
     Instruct woman to empty her bladder first.

     Place woman in dorsal recumbent position, supine with


    knees flexed to relax abdominal muscles. Place a small
    pillow under the head for comfort.
     Drape properly to maintain privacy.

     Wash hands using warm water.

     Explain procedure to the patient.

     Warms hands by rubbing together. (Cold hands can


    stimulate uterine contractions).
     Use the palm for palpation not the fingers.
    PROCEDURES:
    FIRST MANUEVER: Fundal Grip
    1. Palpate the uterus by feeling the upper abdomen with both hands. Head
    feels hard and round, freely movable and balottable.

    WHAT IS THE PURPOSE?


     To determine fetal part lying in the fundus.
     To determine presentation.

    FINDINGS?
    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.
    \
    SECOND MANEUVER: Umbilical Grip
    1. Locate the back of the fetus in relation to the right and left
    side of the mother.
    2. Still facing the client, place the palmar surfaces of the both
    hands on either side of the abdomen and apply gentle but
    deep pressure.
    3. If the hand of one side of the abdomen remains still to steady
    the uterus, a slightly circular motion with the flat surface of
    the fingers on the other hand can gradually palpate the
    opposite side from the top to the lower segment of the uterus
    to feel the fetal outline.
    4. To palpate the other side, the functions of the hands are
    reversed.
    5. On the fetal back, smooth, hard resistant place will be felt;
    side with fetal extremities will feel nodular, reflecting
    portions of fetal extremities
    WHAT IS THE PURPOSE?
     To identify location of fetal back.

     To determine position

    FINDINGS?
    Fetal back is smooth, hard, and resistant surface
    Knees and elbows of fetus feel with a number of angular nodulation
    THIRD MANEUVER: Pawlick’s Grip
    1. Gently grasp the lower portion of the abdomen, just above the
    symphysis pubis between the thumb and the fingers of one
    hand.
    2. Then press together.

    WHAT IS THE PURPOSE?


     To determine engagement of presenting part.

    FINDINGS?
     The presenting part is not engaged if it is not movable.

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


    FOURTH MANEUVER: Pelvic Grip
    1. Face the client’s feet.

    2. The tips of the first 3 fingers are placed on both sides of the
    midline about 2 inches above the Poupart’s ligament.
    3. Pressure is now made downward and the direction of the
    birth canal, the movable skin of the abdomen being carried
    downward along with the fingers.
    4. The fingers of one hand meet no obstruction and be carried
    down ward well under Poupart’s ligament. These fingers
    glide over the nape of the baby’s neck.
    5. The other hand however usually meets an obstruction an
    inch or so above the Pouparts’s ligament. This is the brow of
    the baby and is usually spoken of as the cephalic
    prominence.
    What is the purpose?
     To determine the fetal attitude and the degree of fetal
    extension into the pelvis.
     ! It should be done only if the fetus is in cephalic
    presentation.

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