Leopold’s Maneuver is preferably performed after 24 weeks gestation when fetal outline can be already palpated.

Preparation:
1. Instruct woman to empty her bladder first.
2. Place woman in dorsal recumbent position, supine with knees flexed to relax abdominal muscles. Place a
small pillow under the head for comfort.
3. Drape properly to maintain privacy.
4. Explain procedure to the patient.
5. Warms hands by rubbing together. (Cold hands can stimulate uterine contractions).
6. Use the palm for palpation not the fingers.
Purpose Procedure Findings
First To determine Using both Head is more firm, hard and
Maneuver: fetal part lying hands, feel for round that moves
Fundal Grip in the fundus. the fetal part independently of the body.
To determine lying in the Breech is less well defined
presentation. fundus. that moves only in
conjunction with the body.
Second To identify One hand is Fetal back is smooth, hard,
Maneuver: location of used to steady and resistant surface
Umbilical fetal back. the uterus on Knees and elbows of fetus
Grip To determine one side of the feel with a number of angular
position. abdomen while nodulation
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.
Third To determine Using thumb The presenting part
Maneuver: engagement of and finger, is notengaged if it is not
Pawlik’s Grip presenting grasp the lower movable.
part. portion of the It is not yet engaged if it is
abdomen still movable.
above
symphisis
pubis, press in
slightly and
make gentle
movements
 from side to
side.
Fourth To determine Facing foot Good attitude – if brow
Maneuver: the degree of part of the correspond to the side (2nd
Pelvic Grip flexion of fetal woman, maneuver) that contained the
head. palpate fetal elbows and knees.
To determine head pressing Poor atitude – if examining
attitude or downward fingers will meet an
habitus. about 2 inches obstruction on the same side
above the as fetal back (hyperextended
inguinal head)
ligament. Also palpates infant’s
Use both anteroposterior position. If
hands. brow is very easily palpated,
fetus is at posterior position
(occiput pointing towards
woman’s back)