Leopolds’ maneuver

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Leopolds’ maneuver

  1. 1. LEOPOLDS’ MANEUVER
  2. 2. <ul><li>At the end of the lecture, the students will be able to: </li></ul><ul><ul><li>Identify the steps in performing Leopolds’ Maneuver. </li></ul></ul><ul><ul><li>Identify Nursing considerations in performing Leopolds’ maneuver. </li></ul></ul>
  3. 3. <ul><li>are a common and systematic way to determine the position of a fetus inside the woman's uterus . </li></ul><ul><li>are important because they help determine the position and presentation of the fetus . </li></ul><ul><li>Named after the gynecologist Christian Gerhard Leopold . </li></ul>
  4. 4. <ul><li>Maneuver is preferably performed after 24 weeks gestation when fetal outline can be already palpated. </li></ul><ul><li>The maneuvers are not truly diagnostic . </li></ul><ul><li>Actual position can only be determined by ultrasound performed by a competent technician or professional . </li></ul>
  5. 5. <ul><li>Difficult to perform in obese women. </li></ul><ul><li>Women with hydramios. </li></ul><ul><li>Women with full bladder. </li></ul>
  6. 6. Nursing Considerations <ul><li>Instruct woman to empty her bladder first. </li></ul><ul><li>Place woman in dorsal recumbent position, supine with knees slightly flexed. Place a small pillow under the head for comfort. </li></ul><ul><li>Drape properly to maintain privacy. </li></ul><ul><li>Explain procedure to the patient. </li></ul><ul><li>Warm hands by rubbing together. </li></ul><ul><li>Use the palm for palpation not the fingers . </li></ul>
  7. 7. <ul><li>While facing the woman, palpate the woman's upper abdomen with both hands. </li></ul><ul><li>Often determine the size, consistency, shape, and mobility of the form that is felt. </li></ul><ul><li>The fetal head is hard, firm, round, and moves independently of the trunk . </li></ul><ul><li>The buttocks feels softer, is symmetric , and has small bony prominences; it moves with the trunk . </li></ul>
  8. 8. What lies at the fundus?
  9. 9. <ul><li>The maneuver attempts to determine the location of the fetal back. </li></ul><ul><li>Facing the woman, the health care provider palpates each side of the abdomen with gentle but deep pressure using the tips of his or her hands . </li></ul><ul><li>The fetal back is firm and smooth, hard, resistant surface. </li></ul><ul><li>Fetal extremities feels like small irregularities and protrusions. </li></ul>
  10. 10. Where is the fetal back?
  11. 11. <ul><li>Determine what fetal part is lying above the inlet, or lower abdomen. </li></ul><ul><li>The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. </li></ul>
  12. 12. What is in the inlet?
  13. 13. <ul><li>The health care provider faces the woman's feet , as he or she will attempt to locate the fetus' brow . </li></ul><ul><li>To determine the degree of flexion of the fetal head. </li></ul><ul><li>The fingers of both hands are moved gently down the sides of the uterus towards the pubis . </li></ul>
  14. 14. What is the attitude?
  15. 15. <ul><li>Good attitude </li></ul><ul><ul><li>If brow correspond to the side that contained the elbows and knees. </li></ul></ul>
  16. 16. <ul><li>Poor attitude </li></ul><ul><ul><li>If examining fingers will meet an obstruction on the same side as fetal back. </li></ul></ul>
  17. 17. Thank you all !!!

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