Leopold’s Maneuvers

• What are Leopold’s Maneuvers used for?


  To palpate the gravid uterus systematically.
• Why are Leopold’s Maneuvers considered beneficial?

  They are low cost, easy to perform, and non-invasive.
• What information can be determined using Leopold’s Maneuvers?

  The position, presentation, engagement, and station of the fetus in utero.
• When is it preferable to perform Leopold’s Maneuvers?


  After 24 weeks gestation.
• What is the first prerequisite before performing Leopold’s Maneuvers?

  Explain the procedure and its purpose to the client or patient.
• What should the client do before the procedure of Leopold’s Maneuvers?

  Empty her bladder.
• How should the patient be positioned for Leopold’s Maneuvers?

  In supine position with legs partially flexed from knees.
• What should be ensured about the patient before performing the maneuvers?

  The patient should be comfortable and relaxed.
• What part of the body should be exposed during the procedure?

  The tummy from the xiphoid process to the symphysis pubis.
• Why should the examiner ensure their hands are warm prior to palpation?


  To provide comfort to the patient during the procedure.
• What is the first maneuver in Leopold’s Maneuvers called?


  Fundal Grip.
• What does the first maneuver (Fundal Grip) determine?


  The fetal part (head or buttocks) that occupies the fundus.
• What is measured during the first maneuver?

  Fundal height.
• How should the examiner position themselves to perform the Fundal Grip?

  Stand on the client’s right side facing towards her face.
• What should be documented if the presentation is breech during the Fundal Grip?

  A malpresentation must be documented and confirmed with ultrasound.
• What is the second maneuver in Leopold’s Maneuvers called?

  Lateral or Umbilical Grip.
• What does the second maneuver (Lateral Grip) determine?

  On which maternal side the fetal back is located.
• Why is locating the fetal back important during the second maneuver?

  It is the best location to auscultate the fetal heart sound.
• How should the examiner perform the second Leopold maneuver?


  One hand steadies the uterus while the other moves in a circular motion to feel for fetal back and limbs.
• What is the best place to monitor fetal heart rate during the second maneuver?

  Over the fetal upper back in a vertex presentation.
• What tools can be used to monitor fetal heart rate?

  A fetoscope, stethoscope, or Doppler.
• What is the third maneuver in Leopold’s Maneuvers called?

  Pawlik’s Grip.
• What does the third maneuver (Pawlik’s Grip) determine?


  The engagement of the presenting part.
• Who modified the third maneuver, Pawlik’s Grip?

  Czech Gynecologist named Karel Pawlik.
• How should the examiner perform the third Leopold maneuver?

  Grasp the lower portion of the abdomen above the symphysis pubis and move from side to side.
• What is the fourth maneuver in Leopold’s Maneuvers called?

  Pelvic Grip.
• What does the fourth maneuver (Pelvic Grip) determine?

  The degree of flexion of the fetal head and station.
• How should the examiner perform the fourth Leopold maneuver?

  Face the foot part of the client and palpate the fetal head pressing downward about 2 inches above the inguinal ligament.
• How do you determine the degree of flexion of the fetal head during the fourth maneuver?

  Move the fingers of both hands gently down the sides of the uterus towards the pubis.
• How does determining fetal presentation facilitate fetal heart auscultation?

  The FHT is heard most clearly directly over the fetal upper back in a vertex presentation.
• What is the normal fetal heart rate (FHR)?


  Approximately 120 to 160 beats per minute (bpm).
• When can a Doppler be used to monitor fetal heart rate?

  At 3 months.
• When can a fetoscope be used to monitor fetal heart rate?

  At 4 months.
• When can a stethoscope be used to monitor fetal heart rate?

  Between 5 to 9 months.
• What are the steps involved in performing Leopold’s Maneuvers?

  1. Fundal Grip: Determine fetal part occupying the fundus and measure fundal height.
  2. Lateral Grip: Locate fetal back and limbs, determine position.
  3. Pawlik’s Grip: Assess engagement of the presenting part.
  4. Pelvic Grip: Determine degree of flexion of the fetal head and station.
• What are the key considerations before performing Leopold’s Maneuvers?


  • Explain the procedure and purpose to the client.
  • Obtain verbal consent.
  • Ensure the client is comfortable and relaxed.
  • Position the client appropriately.
  • Ensure hands are warm prior to palpation.