leopold’s maneuver.pptx
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PRE - TESTWRITE T IF THE STATEMENT IS CORRECT AND F IF
IT IS WRONG.
NO ERASURES OR SUPERIMPOSITIONS PLS.ANY ERASURE OR SUPERIMPOSITION WILL BE
CONSIDERED INCORRECT.
USE CAPITAL LETTERS.
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PRETEST :T/F1. Leopolds maneuvers are a systemic method of
observation and palpation to determine fetalpresentation and position. T
2. The position of the woman in leopoldsmaneuver issupine with knees slightly flexed. T
3. Leopolds maneuver is a four part process. - T
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4. Fetal presentation denotes the body part that will firstcontact the cervix or be born first. T
5. Fetal position is the relationship of the presenting partto a specific quadrant of a womans pelvis. T
6. The 3rdmanuever determines the position of the back.F; 2ndmaneuver
7. The 1st
maneuver determines what part is lyingabove the inlet. F; 3rdmaneuver
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LEOPOLDS MANEUVER Four-part process
1. Determine the position of the baby in utero2. Determine the expected presentation during labor
and delivery
Leopolds Maneuver is preferably performed after 24
weeks gestation when fetal outline can be alreadypalpated.
Named after Christian Gerhard Leopold, agynecologist
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Preparation: Instruct woman to empty her bladder first.
Place woman in dorsal recumbent position, supinewith knees flexed to relax abdominal muscles. Place asmall pillow under the head for comfort.
Drape properly to maintain privacy.
Explain procedure to the patient.
Warms hands by rubbing together. (Cold hands canstimulate uterine contractions).
Use the palm for palpation not the fingers.
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Purpose Procedure Findings
First Maneuver:
Fundal Grip
To determine fetal part lying
in the fundus.
To determine presentation.
Using both hands, feel for the
fetal part lying in the fundus.
Head is more firm, hard and round that moves
independently of the body.
Breechis less well defined that moves only in conjunction
with the body.
Second Maneuver:
Umbilical Grip
To identify locationof fetal
back.To determine position.
One hand is used to steady the
uterus on one side of theabdomen while the other hand
moves slightly on a circular
motion from top to the lower
segment of the uterus to feel
for the fetal back and small
fetal parts.
Use gentle but deep pressure.
Fetal backis smooth, hard, and resistant surface
Knees and elbowsof fetus feel with a number of angularnodulation
Third Maneuver:
PawliksGrip
To determine engagement of
presenting part.
Using thumb and finger, grasp
the lower portion of the
abdomen above symphisis
pubis, press in slightly and
make gentle movements from
side to side.
The presenting part is not engaged if it is not movable.
It is not yet engaged if it is still movable.
Fourth Maneuver:
Pelvic Grip
To determine the degree of
flexion of fetal head.
To determine attitude or
habitus.
Facing foot part of the woman,
palpate fetal head pressing
downward about 2 inches
above the inguinal ligament.
Use both hands.
Good attitudeif brow correspond to the side (2nd
maneuver) that contained the elbows and knees.
Poor atitudeif examining fingers will meet an
obstruction on the same side as fetal back (hyperextended
head)
Also palpates infants anteroposterior position. If brow is
very easily palpated, fetus is at posterior position (occiput
pointing towards womans back)
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Leopold's maneuvers are intended to be
performed by health care professionals, asthey have received training and instruction inhow to perform them. That said, as long as
care is taken not to roughly or excessivelydisturb the fetus, there is no real reason itcannot be performed at home as aninformational exercise. It is important to notethat all findings are not truly diagnostic, andas such ultrasound is required to conclusivelydetermine the fetal position.