Leopold’s Maneuver is a method that determines the fetal position, fetal presentation, and engagement. This consists of four different actions that help determine the position and presentation. With correct assessment and findings, it can indicate whether the delivery would be complicated or if the mother would need to undergo Caesarian delivery.
Preparation for Leopold’s Maneuver
Ask the mother to empty the bladder. The nurse should then warm the hands and apply it to the abdomen of the mother by using firm and gentle pressure.
Maneuvers
First Maneuver
This determines what part of the fetus is in the fundus.
- Place palms on each side of the upper abdomen and palpate around the fundus.
- If the head is at the fundus, you would feel a hard, round, and movable object. If the buttocks is at the fundus, you will feel a soft and irregular shaped mass that is difficult to move.
Second Maneuver
- Move your hands downward, still on both sides of the abdomen, while applying firm and even pressure.
- If you palpate a smooth hard surface on one side then it would be the fetal back. If you palpate irregular lumps it would be the hands, feet, elbows, and knees and should be on the opposite side of the abdomen.
Third Maneuver
This maneuver confirms the fetal position.
- Place your hands above the symphysis pubis.
- Bring the thumb and fingers together and grasp the part of the fetus between them. Findings could be the head or the buttocks.
Fourth Maneuver
This is used in the late stage of pregnancy to determine how far the fetus has descended into the pelvic inlet.
- Place your hands on both sides of the lower abdomen close to the midline.
- Slide your hands downward, then press inward.
- If you palpated the buttocks in the fundus, then you shoul feel for the head. If one cannot feel the head, then it probably has descended.
