Leopold'S Maneuver: Definition

LEOPOLD’S MANEUVER
DEFINITION:
- A systematic method of diagnosing the fetal position by external palpation of the mother’s abdomen.
- It is one of the methods in determining fetal presentation.
PURPOSES:
1. to identify number of fetuses.
2. To identify fetal presentation, lie, presenting part, degree of descent and fetal attitude
3. to identify PMI of FHT in relation to the woman’s abdomen
4. to monitor the descent and internal rotation of the fetuses
EQUIPMENT:
- stethoscope
STEPS NURSING RESPONSIBILITIES RATIONALE

1. Wash hands. Follow the steps in doing medical To prevent nosocomial infection.
handwashing.
2. Empty the bladder of the patient. Offer bedpan or assist the patient to To increase maternal comfort
the comfort room.
3. Compute the following: To provide data base for the next
a. OB score steps in the nursing process
b. EDC
c. AOG
4. Do physical assessment.
Procedure:
FIRST MANEUVER
1. Position the patient. Provide one (1) pillow under the To ensure comfort and relieve
woman’s head with her knees slightly tension of abdominal musculature.
flexed.
2. Stand facing the mother. Right-handed should stand at To facilitate examination by using
woman’s right facing her. dominant hand.
3. Palpate the uterine fundus with Observe the following points To determine the content of the
warm hands. according to relative consistency, fundus.
shape and mobility.
4. Determine which part of the body To identify fetal presentation.

lies on the upper fundus.
SECOND MANEUVER
1. Move both hands down on each Place both palms surface on either
sides of the uterus side of the abdomen and apply gentle
pressure. One side of the hand
remains still to steady the uterus
while the other hand does slight
circular motion.
2. Determine which side of the uterus Locate the fetal back in relation to
has the long axis of the fetus is right and left side of the woman’s
located.
abdomen. Feel the fetal outline by
palpation.
3. Check the fetal heartbeat. Listen and count the bat for one full To assess the fetal heart tone
minute. accurately.
Avoid friction noises caused by
fingers on abdominal surface area.
Distinguish other abdominal sounds.
THIRD MANEUVER
1. Grasp the lower uterine segment Find the head at the pelvic inlet. To confirm the presenting part.
with the thumb and fingers.
2. Identify the presenting part. Check for engagement by evaluating To assist in assessing fetal well-being.
mobility.
3. Determine if engagement has

occurred.
FOURTH MANEUVER
1. Face the patient’s feet.
2. press downward on both sides of Palpate just above the inguinal To determine the relationship of the
the patient’s uterus about 2 inches ligament in either side of the presenting part to the pelvis.
above the symphysis pubis. abdomen.
3. Confirm the presenting part.
4. Chart fetal presentation. To provide data base for future

findings.
TIMING OF UTERINE CONTRACTION

PURPOSES:
1. To monitor the progress of woman’s labor
2. to know the frequency, interval and duration
DEFINITIONS:
Contractions – is a rhythmic tightening of the musculature of the upper uterine segment that begins mildly and
becomes very strong late on labor
Types:
 Regular contractions - Contractions are considered regular when the duration and frequency are stable over a
period of time.
 An example is contractions lasting 60 seconds and coming five minutes apart for an hour.
 Irregular contractions - Contractions are irregular when there isn't a stable pattern.
 An example is a series of three contractions lasting between 30 and 45 seconds and coming 10, seven
and then 15 minutes apart.
 Progressing contractions - Contractions that are lasting longer and getting closer together are considered to be
progressing.
 Non-progressing contractions - Contractions that are not getting longer, stronger and closer together. This may
mean that the contractions are not opening the cervix.
Frequency – the rate at which contractions are occurring at a particular time
- - is timed from the start of one contraction to the start of the next. It includes the contraction as well as
the rest period until the next contraction begins. This time is measured in minutes.
Duration – how long the contractions last
- is timed during the first feel of a contraction until it is over. This time is usually measured in seconds.
Intensity - the length of a uterine contraction; the degree of strength or hardness of the uterine contraction
PROCEDURE:
STEPS NURSING RESPONSIBILITIES RATIONALE
1. Explain the procedure to the Follow the steps in doing medical To prevent nosocomial infection.
patient. handwashing.
2. Assist patient to a comfortable To elicit cooperation

supine position with pillow on her
head.
3. Sit on one side of the bed facing

the patient.
4. Rest on hand on the abdomen of Rest hand gently on the fundus of the To enable you to sense the gradual
the woman in labor. uterus upward rising of the fundus
5. Time the frequency and duration. Record the results on your To record the progress of labor.
monitoring sheet.

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LEOPOLD’S MANEUVER

1. to identify number of fetuses.

3. to identify PMI of FHT in relation to the woman’s abdomen

4. to monitor the descent and internal rotation of the fetuses

STEPS NURSING RESPONSIBILITIES RATIONALE

4. Determine which part of the body To identify fetal presentation.

3. Determine if engagement has

1. Face the patient’s feet.

3. Confirm the presenting part.

4. Chart fetal presentation. To provide data base for future

TIMING OF UTERINE CONTRACTION

1. To monitor the progress of woman’s labor

2. to know the frequency, interval and duration

becomes very strong late on labor

Frequency – the rate at which contractions are occurring at a particular time

Duration – how long the contractions last

STEPS NURSING RESPONSIBILITIES RATIONALE

2. Assist patient to a comfortable To elicit cooperation

3. Sit on one side of the bed facing

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