Leopold’s Maneuvers

Leopold’s Maneuvers are methods to determine position, presentation and engagement of fetus.

They will include:

1. Determination of what is in the fundus
2. Evaluation of the fetal back and extremities
3. Palpation of the presenting part above the symphysis, and
4. Determination of the direction and degree of flexion of the head.

How to Perform Leopold’s Maneuver

Before performing Leopold’s Maneuver, ask the mother to empty the bladder, warm hands, and apply them to the mother’s abdomen with firm and gently pressure.

First Leopold’s Maneuver:

1. It will determine which part of the fetus is in the fundus.
2. Place pals on each side of the upper abdomen and palpate around the fundus
3. You would feel a hard, round, movable object if the head is in the fundus
4. You would feel soft and have an irregular shape and are more difficult to move if the buttock is in the fundus

Second Leopold’s Maneuver:

1. Move hand downward over each side of the abdomen, applying firm, even pressure.
2. The fetus’s back which is a smooth, hard surface should be felt on one side of the abdomen.
3. The hands, feet, elbows, and knees which are as irregular knobs and lumps will be felt on the opposite side of the abdomen.

Third Leopold’s Maneuver:

1. It will determine fetal position
2. Place hand above the symphysis pubis
3. Bring thumb and fingers together and grasp the part of fetus between them that may be the head or the buttocks

Fourth Leopold’s Maneuver:

1. It is used in the late stage of pregnancy to determine how far the fetus has descended into the pelvic inlet.
2. Place hand on the sides of the lower abdomen close to the midline
3. Slide hands downward and press inward
4. If you have determined that the buttocks are in the fundus, then feel for the head
5. If you cannot feel the head, it probably has descended

Fundal Height Assessment - Prenatal Care

Fundal Height assessment is measured to evaluate the fetus's gestational age. Fundal height is measured from the top of the symphysis pubis to the top of the fundus. Height is assessed in centimeters.

At 16 weeks, the fundus can be found halfway between the symphysis pubis and the umbilicus. At 20 - 22 weeks, the fundus will be at the umbilicus, and at 36 weeks, the fundus is at xyphoid process. During the second and third trimesters (weeks 18 to 30), fundal height in centimeters approximately equals the fetus's age in weeks plus or minus 2 centimeters.

Remember that picture as it maybe questioned in NCLEX - CGFNS test.

1. To Measure Fundal Height :
2. Place the pregnant woment in the supine position
3. Place the end of the tape measure at the level of the symphysis pubis.
4. Stretch the tape to the top of the uterine fundus, and
5. Record / document the measurement.