Leopold's maneuvers are 4 techniques described in 1894 to determine fetal position in the uterus through abdominal palpation. The document describes each maneuver and their purposes: 1) palpating the uterine fundus to determine fetal lie and position, 2) deep palpation of the abdomen to locate the fetal back, 3) grasping the lower abdomen to confirm fetal presentation, 4) sliding fingers along the inlet to determine degree of fetal descent. The maneuvers allow assessment of fetal position and presentation with 88% sensitivity and 94% specificity.

1. LEOPOLD’S MANEUVERS 1
LEOPOLD’S MANEUVERS
Last updated January 2019
Maria Giroux, HBSc, MD

2. LEOPOLD’S MANEUVERS 2
Leopold’s Maneuvers
• 4 maneuvers described by Leopold in 1894
• Used to diagnose fetal presentation
• Can be used in late pregnancy and
during labour between contractions
• Difficult if obese, polyhydramnios, or
anterior placenta
• Can estimate fetal size
• Poor correlation if obese
Accuracy of Leopold’s
• Sensitivity: 88%
• Specificity: 94%
• PPV (true +): 74%
• NPV (true -): 97%

3. LEOPOLD’S MANEUVERS
Leopold
maneuvers
Leopold’s Maneuvers: Determining Fetal Position in the Uterus [Digital image]. (n.d.). Retrieved from http://sciteachers.tumblr.com/post/146569410584/janellerose-leopolds-maneuvers-determining
[Leopold's maneuvers]. (n.d.). Retrieved from https://medicine.academic.ru/138709/Leopold_maneuvers

4. LEOPOLD’S MANEUVERS 4
1. Uterine Fundus
• Used to determine fetal lie and which fetal pole (cephalic or
podalic) occupies fundus
• Palpate fundus
• Head: round, more mobile
• Breech: large, nodular mass
Leopold’s Maneuvers: Determining Fetal Position in the Uterus [Digital image]. (n.d.). Retrieved from
http://sciteachers.tumblr.com/post/146569410584/janellerose-leopolds-maneuvers-determining
[Leopold's maneuvers]. (n.d.). Retrieved from
https://medicine.academic.ru/138709/Leopold_maneuvers

5. LEOPOLD’S MANEUVERS 5
2. Fetal Orientation
• Used to determine position of fetal back
• Place palms on either side of maternal abdomen, exert gentle deep pressure
• Back: hard, resistant structure
• Directed anteriorly, posteriorly, transversely
• Fetal extremities: numerous small irregular mobile parts
Leopold’s Maneuvers: Determining Fetal Position in the Uterus [Digital image]. (n.d.). Retrieved from
http://sciteachers.tumblr.com/post/146569410584/janellerose-leopolds-maneuvers-determining
[Leopold's maneuvers]. (n.d.). Retrieved from
https://medicine.academic.ru/138709/Leopold_maneuvers

6. LEOPOLD’S MANEUVERS 6
3. Fetal Presentation
• Used to confirm fetal presentation (cephalic vs breech)
• The thumb and fingers of 1 hand grasp the lower portion of maternal
abdomen above pubic symphysis
• Not engaged- movable mass is felt
Leopold’s Maneuvers: Determining Fetal Position in the Uterus [Digital image]. (n.d.). Retrieved from
http://sciteachers.tumblr.com/post/146569410584/janellerose-leopolds-maneuvers-determining
[Leopold's maneuvers]. (n.d.). Retrieved from
https://medicine.academic.ru/138709/Leopold_maneuvers

7. LEOPOLD’S MANEUVERS 7
4. Degree of Descent
• Used to determine the degree of descent
• Face pt’s feet, position fingertips of both hands on either side of the
presenting part à exert inwards pressure, slide caudad along the axis of
pelvic inlet
• When the head has descended, can feet anterior shoulder or the
space created by the neck from the head
Leopold’s Maneuvers: Determining Fetal Position in the Uterus [Digital image]. (n.d.). Retrieved from
http://sciteachers.tumblr.com/post/146569410584/janellerose-leopolds-maneuvers-determining
[Leopold's maneuvers]. (n.d.). Retrieved from
https://medicine.academic.ru/138709/Leopold_maneuvers

8. LEOPOLD’S MANEUVERS 8
References
Cunningham, F., Leveno, K., Bloom, S., Spong, C., Dashe, J., Hoffman, B.,
& Casey, B. (2018). William's obstetrics (25th ed.). New York: McGraw-
Hill Education.