Leopold's maneuver

Leopold's Maneuvers are a common and systematic method used in obstetrics to assess the position of a fetus inside the woman's uterus. They were named after the German gynecologist, Christian Gerhard Leopold, who developed the technique in the late 19th century.

Overview

Leopold's Maneuvers consist of four distinct actions each of which provides information on fetal presentation, position, and engagement. They are typically performed in the third trimester of pregnancy, when the fetus is large enough to be palpated through the abdominal wall.

The Four Maneuvers

1. First Maneuver (Fundal Grip): The examiner palpates the woman's abdomen to determine which end of the fetus is in the upper part of the uterus (the fundus). If the head is felt, the fetus is in a breech position; if the buttocks are felt, the fetus is in a vertex position.
2. Second Maneuver (Umbilical Grip): The examiner determines the location of the fetal back and small parts (limbs). This is done by palpating the sides of the woman's abdomen.
3. Third Maneuver (Pawlik’s Grip or First Pelvic Grip): The examiner determines which fetal part is lying above the pelvic inlet. This is done by grasping the lower portion of the abdomen just above the pubic symphysis.
4. Fourth Maneuver (Second Pelvic Grip): The examiner determines the fetal attitude and degree of flexion by palpating the fundus again.

Clinical Significance

Leopold's Maneuvers are an important part of prenatal care, allowing healthcare providers to assess fetal well-being and to plan for delivery. They can help identify potential complications such as breech presentation, transverse lie, and cephalopelvic disproportion. However, they are not always accurate and may need to be confirmed with an ultrasound.

See Also

• Abdominal examination
• Obstetric ultrasonography
• Pregnancy
• Fetal position

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