Leopold’s Maneuvers

7/29/2019 Leopolds Maneuvers

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Purposes

To determine the number offetuses.

To identify the presentation,

position, degree of descent, andattitude of the fetus.

To identify the point of maximum

intensity of the fetal heart tone inrelation to the womans abdomen.


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Materials

Stethoscope

Doppler


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Procedure

Wash hands. :To deter the spread of microorganisms

Explain the procedure to the patient.

:To gain cooperation

Let the patient empty her bladder deviatebefore the procedure.

Position the patient on supine with one

pillow under her head and with kneesslightly flexed.

: To facilitate accurate assessment providingcomfort. Flexed knees relieve tension of

abdominal musculature


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If right handed, stand at womansright facing the patient.

First Maneuver: Face the patient

and palpate the uterine fundus todetermine what part of the fetuslies in the upper part of the fundus.

:Head feels hard and round, freelymovable and ballotable; breech feelslarge, nodular, and softer.


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Second Maneuver: Palpate in adownward direction on the sides ofthe abdomen applying gentle but

deep pressure to determine theposition of the fetal extremities,fetal back and anterior shoulders.

:On side of fetal back, a longcontinuous structure will be felt; sideof extremities will feel nodular.


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Third Maneuver: Place one handover the symphisis pubis and graspthe lower uterine segment between

the thumb and fingers to feel thepresenting part.

: If engagement has occured, fetalpart feels fixed in the pelvis. The headis at inlet or in pelvis, if the presentingpart is still movable, it is not engaged.


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Fourth Maneuver: Turn and facethe womans feet to confirm thefindings of the third maneuver and

determine the flexion of the fetushead into the pelvis.

:The cephalic prominence is felt onside where there is greater resistanceto the descent of the vertex.


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Locate again the back of the fetus andplace the stethoscope over it and listen tothe fetal heart tone fo one full minute.

:Normal FHT is 120-160 beats per minute.

Note the location, rate and character ofthe FHT

Make the patient comfortable

Document the observation made; fetalfindings, presentation, position, attitudeand whether engaged or floating.

:To promote data base for future.

Leopold’s Maneuvers

Documents

Transcript of Leopold’s Maneuvers