In obstetrics, Leopold maneuvers are a common and systematic way to determine the position of a fetus inside the woman's uterus; they are named after the gynecologist Christian Gerhard Leopold. They are also used to estimate term fetal weight. The aim of Leopold maneuvers is to determine the fetal presentation and position by systematically palpating the gravid abdomen. ctto Marie Belen Tamayor - Leopold's Maneuver, Miss Marie's presentation provided the slides that explain Leopold's maneuver.

1. LEOPOLD’S
MANEUVER
By : Chrisly Bautista
Juvelyn Damuag

2. The Leopold
maneuvers, named
after the German
obstetrician and
gynecologist Christian
Gerhard Leopold
(1846–1911), are part
of the physical
examination of
pregnant women.

3. Why is it
performed?
 The aim of Leopold
maneuvers is to
determine the
fetal presentation
and position by
systematically
palpating the
gravid abdomen,
as well as estimate
your baby's weight.

4.  This process allows
medical professionals to
not only make a birth
weight estimate but also
address any underlying
problems that may
occur down the road.
 This will help you and
your provider be better
prepared for your labor
and determine if it might
be safer to perform

5.  They're also low-cost,
non-invasive, and
don't require the use
of expensive
equipment such as
an ultrasound . Plus
they tell your provider
how ready your baby is
for birth so they can
better prepare for your
labor.

6.  Leopold’s preferably
performed after 24
weeks of gestation
(about 6 months).
[Maneuver’s are not truly
diagnostic
Actual position can only be
determined by ultrasound
performed by a competent
professional. ]

7. Factors Affecting
 Difficult to
perform in obese
women.
 Women with
hydramnios
 Women with full
bladder.

8. What are the 4
maneuver?
 First maneuver:
fundal grip.
 Second maneuver:
lateral grip.
 Third maneuver:
second pelvic grip
or Pawlik's grip.
 Fourth maneuver:
Leopold's first pelvic
grip.

9. Nursing Considerations
 Instruct the women
to empty her
bladder
 Wash hands (then
dry)
 Provide privacy
 Verify the client
 Explain procedure
 Place woman in
dorsal recumbent
position.

10. Nursing Considerations
 Warm hands by
rubbing together
 Use the palm for
palpation not the
fingers.

11. FIRST MANEUVER:
 FUNDAL GRIP
 What lies in the fundus?
 While facing the
woman, palpate the
upper part abdomen
with both hands
 Often determine the
size, consistency,
shape and mobility
of the form that is
felt.

12. FIRST MANEUVER:
 The fetal head is
hard, firm, round
and moves
independently of the
trunk.
 While the buttocks,
feel softer. It’s
symmetric and has
small bony
prominences; it
moves w/ the trunk.

13. SECOND MANEUVER:
 LATERAL GRIP
 Where is the fetal back?
 Facing the woman,
the health care
provider palpates
each side of the
abdomen with gentle
but deep pressure
using the tip of
his/her hands.

14. SECOND MANEUVER:
 The fetal back is firm
and smooth, hard,
resistant surface.
 Fetal extremeties
feels like small
irregularities and
protrusions.

15. THIRD MANEUVER:
 PAWLIK’S GRIP
 What is in the inlet?
 To determine what
fetal part is lying
above the inlet or
lower abdomen.
 The individual
performing the
maneuver, first grasps
the lower portion of the
abdomen just above the
symphysis pubis w/ the
thumb and fingers of the
right hand

16. FOURTH MANEUVER:
 PELVIC GRIP
 What is the attitude?
 The health care
provider faces the
woman’s feet, as he
or she will attempt to
locate the fetus’
brow.
 To determine the
degree of flexion of
the fetal head

17. FOURTH MANEUVER:
 The fingers of both
hands are moved
gently down the
sides of the uterus
towards the pubis

18. ATTITUDE describes the position of the parts of your baby's body. The normal fetal attitude
is commonly called the fetal position. The head is tucked down to the chest. The arms and legs
are drawn in towards the center of the chest.
 Good attitude – if brow correspond to the side that contained the elbows and knees
 Poor attitude – If examining, fingers will meet obstruction on the same side as fetal back

19. IDEAL POSITION
A t the beginning of yo ur
pregnancy, your baby will move
around your womb freely, but
towards the end, they should get
into a certain position. Before
birth, your baby should be head-
down, facing your back, with its
chin tucked to its chest so that its
head is ready to enter the pelvis.
This is called the cephalic
presentation and it is the ideal
p o s i t i o n f o r d e l i v e r y .
Most babies will settle into this
position between the 32nd and
36th week of your pregnancy.
This position makes labor less
complicated. Around 96% of
babies will be born in the
c e p h a l i c p o s i t i o n .

20. Abnormal Position &
Presentations
Cephalic Posterior
Position
This position is also known
as an occiput position or it's
sometimes nicknamed
"sunny-side-up." It means
that your baby is positioned
head down, but they're
facing out instead of
towards your spine. This
position could increase
your chances of a painful
and prolonged delivery.

21. Abnormal Position &
Presentations
Breech Position
A breech position means that
your baby's bottom is facing
downwards. There are three
different breech positions:
Frank breech: The baby's legs
are up with feet near the head
Footling breech: One or both
legs is lowered in the cervix
Complete breech: The baby's
bottom is first and its knees are
bent
Any of these positions can
make for a riskier delivery so
you are at risk of a C-section
delivery if the baby doesn't
change position before labor.

22. Abnormal Position &
Presentations
Transverse Lie
Your baby might also be in
a transverse lie position at
the end of the third
trimester, which means
they are lying sideways
across your uterus instead
of vertically. If they don't
change position, it could
make for dangerous labor,
so a C-section will be
required.

23. Other presentations
In face presentation, the neck arches back so that the face presents first.
In brow presentation, the neck is moderately arched so that the brow presents first.