MISAMIS UNIVERSITY

Ozamiz City 7200, Philippines

CERTIFIED: ISO 9001:2015 Risk Management – Det Norske Veritas, The Netherlands
ACCREDITED: Philippine Association of Colleges and Universities Commission on Accreditation (PACUCOA)

LEOPOLD’S MANEUVER

DEFINITION: It is a systematic abdominal palpation to determine position and

PURPOSE: 1. To identify fetal presentation, the presenting part, lie, attitude and degree
of descent.
2. To estimate the size and number of fetus.

EQUIPMENT: Drape

PROCEDURE RATIONALE
1. Identify the client and explain the Knowing the client prevents error.
procedure. Giving information allays fear and anxiety
thus gaining maternal cooperation.
2. Instruct the client to empty or void her To promote comfort on the part of the client.
bladder.
3. Position the client in dorsal recumbent. Proper positioning relaxes both mother and
baby. It also facilitates the easy location of the
fetus, and its presentation and lie.
4. Drape client and expose the abdomen To provide privacy.
from the level of the xiphoid process down
to the symphysis pubis.
5. Warm both hands by rubbing one against The use of warm hands during palpation
the other before placing them on the prevents tension and hardening of the
abdomen. abdominal muscles favoring good results.
6. Perform the four maneuvers. During the The position favors accurate performance of
first three maneuvers, the examiner stands the maneuvers.
at the side of the (client) bed and faces the
client.
FIRST MANEUVER
With both hands, palpate upper To determine the fetal part lying in the fundus
abdomen and fundus for: of the uterus.
 MISAMIS UNIVERSITY
Ozamiz City 7200, Philippines
Tel No. +63 88 521-0367 / Telefax No. +63 88 521-2917
E-mail Address: [email protected]

CERTIFIED: ISO 9001:2015 Risk Management – Det Norske Veritas, The Netherlands
ACCREDITED: Philippine Association of Colleges and Universities Commission on Accreditation (PACUCOA)

LEOPOLD’S MANUEVER

PROCEDURE RATIONALE
CONSISTENCY – head is round,
hard; breech is well-defined
MOBILITY – head moves
independently; breech is less mobile
SECOND MANEUVER
With both hands moving down, To determine the fetal back for fetal heart
palpate the sides of the uterus from the tone, usually found in the left lower quadrant.
top to bottom.
Findings:
• One side – smooth, hard, resistant
surface (back)
• Other side – angular nodulation
(knees and elbows)
THIRD MANEUVER
With the right hand over the To determine engagement of the presenting
symphysis pubis, identify the part.
presenting part by grasping the lower
abdomen with thumb and fingers.
Assess whether the presenting part is
engaged in the pelvis.
(if head is engaged, it will not move)
(if it is soft, it is the back)
FOURTH MANEUVER
The nurse alters position by turning To determine the degree of flexion of the fetal
towards the patient’s feet. With both head.
hands, assess the descent of the
presenting part by locating the
cephalic prominence of brow.
A. Place your fingers on both sides of
the uterus, about two inches above
the inguinal ligaments. Press
downward and inward.
 MISAMIS UNIVERSITY
Ozamiz City 7200, Philippines
Tel No. +63 88 521-0367 / Telefax No. +63 88 521-2917
E-mail Address: [email protected]

CERTIFIED: ISO 9001:2015 Risk Management – Det Norske Veritas, The Netherlands
ACCREDITED: Philippine Association of Colleges and Universities Commission on Accreditation (PACUCOA)

LEOPOLD’S MANUEVER

PROCEDURE RATIONALE
B. On one hand, if the fetal back is
palpated, it meets no obstruction.
C. On the other hand, it will meet
obstruction if the fetal brow is
palpated.
7. Assess the fetal heart tone. It is best heard To have an accurate result and for baseline
on the side of the fetal back. data.
A. Warm the bell of stethoscope by
rubbing it over the palm of your
hand.
B. Listen to the fetal heart tone for
one full minute.
8. Reposition the client. To make the client feel comfortable.
9. Record/chart any abnormal observation To provide baseline data for the mother and
and findings on the mother and baby. baby.
Adapted from: Adion & Dizon. (2009). Manual & Checklists on Health Care Procedures.