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Leopolds Maneuvers
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are a systematic method of observation and palpation to determinefetal position, presentation, lie
and attitude. It is preferably performed after 24 weeks gestationwhen fetal outline can be palpated
first by rubbing them together before placing them over the womansabdomen to aid comfort.
Rationale: Cold hands may stimulate uterine contractions
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PROCEDURES
(1)Midwife stands at the side of the bed, facing the client
(2)Using both hands, feel for the fetal par lying in the fundus
FINDINGS
-The midwife-midwife should ascertain what is lying at the fundus by feeling theupper abdomen (fundus)
with tips of both hands. Generally, she will find there isa mass, which will either be the head or
the buttocks (breech) of he fetus. Themidwife-midwife must decide which pole of the fetus; it is by
observing
Three points
1.Relative consistency - the head is harder/ firmer than the breech
2.Shape - if the head, it will be round and hard, and the transverse groove of the neck maybe felt. The
breech has no groove and usually feels more angular
3.Mobility - the head will move independently of the trunk; but the breech moves only inconjunction with
the body-If the midwife-midwife feels the head, the fetus is in breech presentation; if the midwifemidwifefeels the buttocks, it means the fetus is in vertex presentation
SECOND MANEUVER/ Umbilical Grip/LM2
: Which side is the fetal back?-to locate/identify the
fetal back in relation to the right and left sides of the mother
fetal position (the relationship of the presenting part to one of the quadrantsof the mothers pelvis
PROCEDURES
(1)The midwife-midwife places the palmar surfaces of both hands on either side of the abdomen.
(2) With left palm stationary on the left side of the abdomen to steady theuterus the right palpates the right
side of the uterus on a circular motionfrom top to lower segment of the uterus applying gentle but deep
pressureto palpate the fetal outline and small fetal parts
(3)The midwife-midwife then reverses her hands.
FINDINGS
-Small fetal parts (knees and elbows) feel nodular with numerous angular nodulations-Fetal back feels
smooth, hard, like a resistant surface
THIRD MANEUVER/ Pawliks Grip/LM3
: What fetal part lies above the pelvic inlet?-determine if the
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