Leopold Maneuvers

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Outline

Overview

  1. Leopold maneuvers involve systematically palpating the mother’s abdomen/uterus to feel the fetal position

Nursing Points

General

  1. Determine the position of the fetus
  2. Assist examiner in estimating a location for fetal heart sounds

Assessment

  1. Fundal grip
    1. Head will feel hard, round and moveable
    2. Baby’s bottom will feel irregular
  2. Umbilical grip
    1. Should feel smooth back on one side
    2. Should feel irregular bumps and lumps on the side to indicate fingers, toes, knees
  3. 1st Pelvic Grip
    1. Performed facing the mother
    2. Determines which part is engaged
  4. 2nd Pelvic Grip
    1. Performed facing mom’s feet
    2. Determines flexion or extension of the baby’s head if this is the presenting part

Therapeutic Management

  1. Laying comfortable
  2. Empty bladder

Nursing Concepts

  1. Reproduction
  2. Comfort

Patient Education

  1. What we are doing
    1. Assessing for location and presenting part
    2. Assessing to get best fetal heart tones
  2. Empty bladder

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Transcript

In this lesson I will explain the use of leopold’s maneuver and how this is incorporated into practice.

So what is this maneuver and why do we do it? It is a palpation of the mother’s abdomen or uterus. It is done so we can feel the fetal position. Why would we need to know this? We need to know what the presenting part is. We need to make sure the fetus is head down. We need to know where the fetal back is because this is where we put the monitor to detect the fetal heart rate. So let me explain why because I know that seems weird. If a fetus is curled up in a fetal position then we can’t access the heart to put it on. Also the back is a large surface area so we can easily get the monitor against the fetal back.
Let’s look at the maneuvers so there are four different maneuvers. First is the fundal grip. If there is a head it will feel hard, round and moveable. If it is a bottom then it will feel harder and irregular. The next is Umbilical grip. You are feeling on the sides and should feel a smooth long back on one side. The other side should feel irregular bumps and lumps on the side which is going to indicate fingers, toes, and knees. The next is the first pelvic grip. This is done by facing the mother. And this will determine which part is the presenting part andis engaged. The second pelvic grip is done by facing the mother’s feet and will determine if it is flexion or extension of the baby’s head. Of course this grip only works if it is the head that is the presenting part.
Our management for this patient is really just to make sure she is laying back comfortable. This is a lot of pushing and maneuvering to assess the fetal position. It will be helpful to ensure the patient has an empty bladder as well because of all the manipulation. We are looking for the presenting part and determining the best location to assess heart tones.

Comfort and reproduction will be our nursing concepts. We need to keep the patient comfortable during this and has reproduced.

Let’s review the key points. The leopold’s maneuver is done to assess where the fetal back is for heart tones and to determine the presenting part. Do do this the fundal maneuver is first assessed. And this is done by pressing at the top of the uterus, the fundus. Next the umbilical grip and this is feeling the sides. The last two are pelvic grip. The first is facing the mother to feel in the pelvis at what the presenting part is. The next pelvic is done at the maternal head. This is done if the head is determined to be in the pelvis to find if it is flexed or extended. So what do we feel? If it is firm and moveable ball it is the head. If it is firm, irregular it is the fetal butt. If you feel small bumps these are fists and knees.

Make sure you check out the resources attached to this lesson. Find a friend and practice the maneuvers as well as reviewing what each part feels like. Now, go out and be your best selves today. And, as always, happy nursing.

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Concepts Covered:

  • Prenatal Concepts
  • Pregnancy Risks
  • Postpartum Complications
  • Fetal Development
  • Labor and Delivery
  • Labor Complications
  • Postpartum Care
  • Newborn Care
  • Newborn Complications
  • Integumentary Disorders
  • Liver & Gallbladder Disorders
  • Microbiology

Study Plan Lessons

OB Course Introduction
OB Course Introduction
OB Course Introduction
Gestation & Nägele’s Rule: Estimating Due Dates
Gestation & Nägele’s Rule: Estimating Due Dates
Gestation & Nägele’s Rule: Estimating Due Dates
Fundal Height Assessment for Nurses
Fundal Height Assessment for Nurses
Fundal Height Assessment for Nurses
Physiological Changes
Physiological Changes
Physiological Changes
Discomforts of Pregnancy
Discomforts of Pregnancy
Discomforts of Pregnancy
Nutrition in Pregnancy
Nutrition in Pregnancy
Nutrition in Pregnancy
Abortion in Nursing: Spontaneous, Induced, and Missed
Abortion in Nursing: Spontaneous, Induced, and Missed
Abortion in Nursing: Spontaneous, Induced, and Missed
Anemia in Pregnancy
Anemia in Pregnancy
Anemia in Pregnancy
Cardiac (Heart) Disease in Pregnancy
Cardiac (Heart) Disease in Pregnancy
Cardiac (Heart) Disease in Pregnancy
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hydatidiform Mole (Molar pregnancy)
Hydatidiform Mole (Molar pregnancy)
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Gestational HTN (Hypertension)
Gestational HTN (Hypertension)
Infections in Pregnancy
Infections in Pregnancy
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
HELLP Syndrome
HELLP Syndrome
HELLP Syndrome
Fertilization and Implantation
Fertilization and Implantation
Fertilization and Implantation
Fetal Development
Fetal Development
Fetal Development
Fetal Environment
Fetal Environment
Fetal Environment
Fetal Circulation
Fetal Circulation
Fetal Circulation
Process of Labor
Process of Labor
Process of Labor
Mechanisms of Labor
Mechanisms of Labor
Mechanisms of Labor
Leopold Maneuvers
Leopold Maneuvers
Leopold Maneuvers
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring (FHM)
Obstetrical Procedures
Obstetrical Procedures
Obstetrical Procedures
Prolapsed Umbilical Cord
Prolapsed Umbilical Cord
Prolapsed Umbilical Cord
Placenta Previa
Placenta Previa
Placenta Previa
Abruptio Placentae (Placental abruption)
Abruptio Placentae (Placental abruption)
Abruptio Placentae (Placental abruption)
Precipitous Labor
Precipitous Labor
Precipitous Labor
Dystocia
Dystocia
Dystocia
Postpartum Physiological Maternal Changes
Postpartum Physiological Maternal Changes
Postpartum Physiological Maternal Changes
Postpartum Interventions
Postpartum Interventions
Postpartum Interventions
Postpartum Discomforts
Postpartum Discomforts
Postpartum Discomforts
Breastfeeding
Breastfeeding
Breastfeeding
Postpartum Hematoma
Postpartum Hematoma
Postpartum Hematoma
Subinvolution
Subinvolution
Subinvolution
Postpartum Thrombophlebitis
Postpartum Thrombophlebitis
Postpartum Thrombophlebitis
Initial Care of the Newborn (APGAR)
Initial Care of the Newborn (APGAR)
Initial Care of the Newborn (APGAR)
Newborn Physical Exam
Newborn Physical Exam
Newborn Physical Exam
Body System Assessments
Body System Assessments
Body System Assessments
Newborn Reflexes
Newborn Reflexes
Newborn Reflexes
Babies by Term
Babies by Term
Babies by Term
Transient Tachypnea of Newborn
Transient Tachypnea of Newborn
Transient Tachypnea of Newborn
Retinopathy of Prematurity (ROP)
Retinopathy of Prematurity (ROP)
Retinopathy of Prematurity (ROP)
Erythroblastosis Fetalis
Erythroblastosis Fetalis
Erythroblastosis Fetalis
Addicted Newborn
Addicted Newborn
Addicted Newborn
Newborn of HIV+ Mother
Newborn of HIV+ Mother
Newborn of HIV+ Mother
Tocolytics
Tocolytics
Tocolytics
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone
Magnesium Sulfate
Magnesium Sulfate
Magnesium Sulfate
Opioid Analgesics
Opioid Analgesics
Opioid Analgesics
Prostaglandins
Prostaglandins
Prostaglandins
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin)
Meds for PPH (postpartum hemorrhage)
Meds for PPH (postpartum hemorrhage)
Meds for PPH (postpartum hemorrhage)
Rh Immune Globulin (Rhogam)
Rh Immune Globulin (Rhogam)
Rh Immune Globulin (Rhogam)
Lung Surfactant
Lung Surfactant
Lung Surfactant
Eye Prophylaxis for Newborn (Erythromycin)
Eye Prophylaxis for Newborn (Erythromycin)
Eye Prophylaxis for Newborn (Erythromycin)
Phytonadione (Vitamin K)
Phytonadione (Vitamin K)
Phytonadione (Vitamin K)
Hb (Hepatitis) Vaccine
Hb (Hepatitis) Vaccine
Hb (Hepatitis) Vaccine
Antepartum Testing
Antepartum Testing
Antepartum Testing
Chorioamnionitis
Chorioamnionitis
Chorioamnionitis
Disseminated Intravascular Coagulation (DIC)
Disseminated Intravascular Coagulation (DIC)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Ectopic Pregnancy
Ectopic Pregnancy
Family Planning & Contraception
Family Planning & Contraception
Family Planning & Contraception
Fetal Alcohol Syndrome (FAS)
Fetal Alcohol Syndrome (FAS)
Fetal Alcohol Syndrome (FAS)
Gestational Diabetes (GDM)
Gestational Diabetes (GDM)
Gestational Diabetes (GDM)
Gravidity and Parity (G&Ps, GTPAL)
Gravidity and Parity (G&Ps, GTPAL)
Gravidity and Parity (G&Ps, GTPAL)
Hyperbilirubinemia (Jaundice)
Hyperbilirubinemia (Jaundice)
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Hyperemesis Gravidarum
Hyperemesis Gravidarum
Incompetent Cervix
Incompetent Cervix
Incompetent Cervix
Mastitis
Mastitis
Mastitis
Maternal Risk Factors
Maternal Risk Factors
Maternal Risk Factors
Meconium Aspiration
Meconium Aspiration
Meconium Aspiration
Menstrual Cycle
Menstrual Cycle
Menstrual Cycle
Postpartum Hemorrhage (PPH)
Postpartum Hemorrhage (PPH)
Postpartum Hemorrhage (PPH)
Premature Rupture of the Membranes (PROM)
Premature Rupture of the Membranes (PROM)
Premature Rupture of the Membranes (PROM)
Preterm Labor
Preterm Labor
Preterm Labor
Signs of Pregnancy (Presumptive, Probable, Positive)
Signs of Pregnancy (Presumptive, Probable, Positive)
Signs of Pregnancy (Presumptive, Probable, Positive)