LEOPOLD'S

• Leopold's Maneuver


  Systematic method of observation and palpation to determine the fetal presentation and position
• Purposes of Leopold's Maneuver


  • First Maneuver: To determine the presentation of the fetus and the part which occupies the fundus
  • Second Maneuver: To determine the fetal position and the location of fetal back which aids in the location of fetal heart tone
  • Third Maneuver: To determine descend of the presenting part of the fetus to the birth canal
  • Fourth Maneuver: To determine degree of flexion of the fetal head and to determine fetal attitude or habitus
• Leopold's Maneuver: Assessment


  Review the available pre-natal health record of the client to determine the Last Menstrual Period (LMP), Expected date of Confinement (EDC) and Age of Gestation (AOG)
• Leopold's Maneuver: Planning


  1. Gather all the necessary equipment needed

  2. 1.1 linen

  3. 1.1 Divider

  4. 1.3 tape measure

  5. 1.4 Stethoscope/ Doppler if available

  6. 1.5 Pillow

  7. 1.6 gel

  8. 1.7 tissue paper
• Leopold's Maneuver: Implementation


  1. Introduce self to the client

  2. Explain the purpose of the procedure to the client as well as how the procedure will be done

  3. Instruct client to empty her bladder before doing the procedure

  4. Perform personal hand hygiene using warm water

  5. Provide privacy for the client by using a divider and draping the client with linen below the hips

  6. Position the client supine with knees slightly flexed. Place a small pillow or towel under her right side

  7. Expose the client's abdomen and observe for the longest diameter and where fetal movements are apparent

  8. Measure the fundic height in centimeters
• First Maneuver: Fundal Grip

  1. Palpate the superior portion of fundus to determine consistency, shape and mobility

  2. Head is more firm, hard and round that moves independently of the body

  3. Breech is less well defined that moves only in conjunction with the body
• Second Maneuver: Umbilical Grip

  1. Face the patient and place the palms of each hand on either side of the abdomen

  2. Palpate the sides of the uterus to locate the fetal back

  3. Place the diaphragm of the stethoscope on the side where the fetal back is located and establish the location of the fetal heart tone and count for 1 full minute

  4. If a doppler device is available, apply a dollop of water-soluble gel on the midline, halfway between the symphysis pubis and the umbilicus, turn on the doppler device and listen for the fetal heart sounds, adjusting the volume as needed

  5. Compare the audible heart sounds with your patient's pulse to distinguish fetal heart sounds from mother's heart sounds
• Fetal Heart Tone (FHT)
• Third Maneuver: Pawlik's Grip

  Gently grasp the lower portion of the abdomen just above symphysis pubis between the thumb and index finger, and try to press the thumb and finger together to determine if the presenting part is engaged or not
• Fourth Maneuver: Pelvic Grip


  1. Face the foot part of the woman

  2. Place fingers on both sides of the uterus approximately 2 inches above the inguinal ligaments, pressing downward and inward in the direction of the birth canal

  3. Determine fetal attitude and degree of fetal extension into the pelvis
• Findings from Fourth Maneuver