Leopold's Maneuver

Leopold's maneuver are a systematic method of observation and palpation to determine fetal position, presentation, lie and attitude which helps in predicting course of labor.

• The woman should lie in supine position with knees flexed slightly.
• hands should be warm to avoid abdominal contraction
• done with empty bladder
  

Keen observation of abdomen should give data about

1. longest diameter in appearance
2. location of apparent fetal movement

The four Leopold's maneuver are:

1. First Maneuver
- to determine presenting part at the fundus
head is round and hard, breech is less defined

2. Second Maneuver
- to determine fetal back
- one hand: will feel smooth, hard resistant surface (the back) and the opposite side, a number of angular nodulation (knees and elbows of fetus)

3. Third Maneuver
- to determine position and mobility of presenting part
- if the presenting part moves upward so the examiner's hand can be pressed together, then presenting part is not engaged

4. Fourth Maneuver
- to determine fetal descent
- fingers are pressed in both side of the uterus approximately 2 inches above the inguinal ligaments, then press upward and inward.

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