LEOPOLD'S MANEUVER FETAL PRESENTATION FETAL ATTITUDE FETAL LIE FETAL POSITION The Leopold maneuvers are used to palpate the gravid uterus systematically. This method of abdominal palpation is of low cost, easy to perform, and non-invasive. It is used to determine the position, presentation, and engagement of the fetus in utero. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation.

1. Pre-natal Care
(Leopold’s Maneuver)

2. FETAL PRESENTATION
FETAL ATTITUDE
FETAL LIE
FETAL POSITION

3. Cephalic
Breech
Scapula - shoulder
FETAL PRESENTATION
- denotes the body part that will contact the
cervix. This is determined by a combination of fetal
lie and the degree of fetal flexion.

4. FETAL PRESENTATION - CEPHALIC

5. FETAL PRESENTATION - BREECH
COMPLETE INCOMPLETE FOOTLING
(FULL) (FRANK) (SINGLE/DOUBLE FOOTLING)

6. FETAL PRESENTATION - BREECH

7. FETAL PRESENTATION – SCAPULA/SHOULDER
TRANSVERSE OR SHOULDER

8. FETAL ATTITUDE
- the degree of flexion a fetus assumes during labor
labor or the relation of the fetal parts to each other

9. FETAL LIE
– relationship of the fetal spine to the maternal
spine

11. FETAL POSITION
- relationship of the denominator or landmark of the
presenting part to the mother’s pelvis
 Indicated by three letters abbreviation
1. Identify which side the presenting part is facing the pelvis
R (right)
L (left)
2. Identify the landmark that is presenting
O – occiput or head
S – sacrum or buttocks
Sc – scapula or shoulder
M – mentum or chin
3. Identify the direction the presenting part is facing in the pelvis
A – anterior
P – posterior
T – transverse

13. Possible Fetal Breech Position
(sacrum)
LSaA, left sacroanterior
LSaP, left sacroposterior
LSaT, left sacrotransverse
RSaA, right sacroanterior
RSaP, right sacroposterior
RSaT, right sacrotransverse

14. Possible Fetal Face Position
(mentum)
LMA, left mentoanterior
LMP, left mentoposterior
LMT, left mentotransverse
RMA, right mentoanterior
RMP, right mentoposterior
RMT, right mentotransverse
right mentoanterior right mentotransverse right mentoposterior
left mentoanterior left mentotransverse left mentoposterior

15. Possible Fetal Shoulder Position
(acromion process)
LAA, left scapuloanterior
LAP, left scapuloposterior
RAA, right scapuloanterior
RAP, right scapuloposterior
V
right scapuloposterior
right scapuloanterior
left scapuloposterior
left scapuloanterior

16. LEOPOLD’S MANEUVER
- is a systematic method of palpation of the
abdomen of pregnant women to determine fetal
presentation, attitude, lie and position. It has 4
maneuver:
 First maneuver or Fundal Grip
 Second maneuver or Umbilical Grip
 Third maneuver or Pelvic Grip
 Fourth maneuver or Pawlik’s Grip

17. LEOPOLD’S MANEUVER
Procedure:
 Preparatory Phase
 Explain the procedure to the patient
 Ask to empty her bladder
 Wash hands and observe infection control procedures
 Position the client to dorsal recumbent, with pillows under head
 Ask the client to bare her abdomen from the lower rib margin to the pubic bone
 Drape appropriately
 Warm your hands
 Observe client’s abdomen for longest diameter and where the fetal movement is
apparent

18. First Maneuver – FUNDAL GRIP
 Face the head part of the client.
 While facing the woman, place the
hands on the top of the uterus
(fundus) and palpate.
 Palpate the superior surface of the
fundus. Determine consistency,
shape and mobility.

19. Second Maneuver – UMBILICAL GRIP
 Still facing the woman, put both
hands on either side of the
abdomen, applying gentle but
deep pressure.
 Place hand stabilizes the one side
of the uterus, the other hand
palpates the opposite side
 Repeat the same procedure on the
opposite side

20. Third Maneuver – PAWLIK’S GRIP
 While facing the woman, grasp the lower
uterine segment between the thumb and
fingers of one hand just above the
symphysis pubis.
 Press in slightly, using thumb and finger
and make gentle movements from side to
side.
 Determine any movement and whether the
part is soft or firm.

21. Fourth Maneuver – PELVIC GRIP
 Face the client’s foot part, place palm on the
sides of the abdomen, just above the
inguinal ligament.
 Grasp snugly the lower abdomen and with
the outstretched thumb, meeting at the
umbilical level. Place the fingers on both
sides of uterus approximately 2 inches
above the inguinal ligaments, pressing
downward and inward in the direction of the
birth canal.

22. Identify correctly the degree of flexion, position and station of the
presenting part.
Make no unnecessary exposure of client’s body and return to
position.
Explain the findings to the woman.
Wash hands.
Document the result.

24. THANK YOU 