Leopolds Manuever

Republic of the Philippines
Biliran Province State University

(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing & Health Sciences
NAME OF STUDENT: DATE: _______________
Leopold’s Maneuver
Purposes:
 Systematically observing and palpating the abdomen to determine fetal presentation and position
i.e. lie, attitude, and descent
 To aid in location of fetal heart rates
 To aid in assessment of fetal size
 To determination of single versus multiple gestation
Equipment:
 Blanket
 Small Towel
 Pillow
PROCEDURE STEPS RATIONALE 4 3 2 1

1. Prepare the materials needed. Before the procedure I’ve
already prepared the
equipment such as blanket,
small towel and pillow.
2. Prepare the client.
a. Explain the procedure. Explanation reduces anxiety
and enhances cooperation.
b. Instruct the client to empty her Promotes comfort and allows
bladder. for more productive palpation
because fetal contour will not
be obscured by a distended
bladder.
c. Position the woman supine with knees Flexing the knees relaxes and
slightly flexed. Place a small pillow or abdominal muscles. Using
rolled towel under one side. pillow or towel tilts the uterus
off the vena vaca, thus
preventing supine
hypotension syndrome.
d. Wash your hands using warm water. Handwashing to prevent the
spread of possible infection.
Using warm water aids in
client comfort and prevent
tightening of abdominal
muscles.
e. Observe privacy. Expose the abdomen To keep the safety and client’s
of the pregnant woman. privacy.
f. Observe the woman’s abdomen for The longest diameter (axis) is
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longest diameter and where fetal the length of the fetus. The
movement is apparent. location of activity most likely
reflects the position of the
feet .
3. Perform the first maneuver.
a. Stand at the foot of the client, facing This maneuver determines
her, and place both hands flat on her whether fetal head or breech
abdomen. in the fundus. Proper
positioning of hands ensures
accurate findings.
b. Palpate the superior surface of the Head is more firm, hard and
fundus. Determine consistency, shape, round that moves
and mobility. independently of the body.
Breech is less well defined
that moves only in
conjunction with the body.
4. Perform the second maneuver.
a. Face the client and place the palms of This maneuver is most
each hand on either side of the successful to determine the
abdomen. direction the fetal back is
facing. One Hand will feel a
smooth, hard, resistant
surface (the back). While on
the opposite side, a number of
angular nodulation (the knees
and elbows of the fetus) will
be felt.
b. Palpate the sides of the uterus. Hold Fetal back is smooth, hard,
the left hand stationary on the left side and resistant surface Knees
of the uterus while the right hand and elbows of fetus feel with a
palpates the opposite side of the number of angular nodulation.
uterus from top to bottom. Then hold
the right hand steady, and repeat
palpation using the left hand on the left
side.
5. Perform the third maneuver.
a. Gently grasp the lower portion of the The presenting part is
abdomen just above the symphysis notengaged if it is not
pubis between the thumb and index movable. It is not yet engaged
finger and try to press the thumb and if it is still movable.
finger together. Determine any
movement and whether the part is firm
or soft.
6. Perform the fourth maneuver.
a. Place fingers on both sides of the Good attitude – if brow
uterus approximately 2 inches above correspond to the side (2nd
the inguinal ligaments, pressing maneuver) that contained the
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downward and inward in the direction elbows and knees. Poor

of the birth canal. Allow fingers to be atitude – if examining fingers
carried downward. will meet an obstruction on
the same side as fetal back
(hyperextended head) Also
palpates infant’s
anteroposterior position. If
brow is very easily palpated,
fetus is at posterior position
(occiput pointing towards
woman’s back).
7. Document the procedure and any pertinent Documented all the findings
observations. right after the assessment.
8. Do after care. The patient was okay or calm
and ease before and after the
assessment. Given an update
on her physical assessment.
And an after care on the
assessment done.
SCORE: ______________________
REMARKS:
_______________________________________________________________________________________
_______________________________________________________________________________________
SIGNATURE OF STUDENT: _________________________________
SIGNATURE OF CLINICAL INSTRUCTOR: ______________________
Tel. (053) 507-0082‫ ן‬Telefax. (053) 507-0082
#WoWBiPSU!

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Republic of the Philippines

Biliran Province State University

NAME OF STUDENT: DATE: _______________

PROCEDURE STEPS RATIONALE 4 3 2 1

downward and inward in the direction elbows and knees. Poor

SIGNATURE OF STUDENT: _________________________________

SIGNATURE OF CLINICAL INSTRUCTOR: ______________________

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