The fundus is palpated with the fingertips of both hands facing toward the maternal xiphoid cartilage. Maneuver I: The uterine contour is outlined. (Pritchard JA, MacDonald PC: William's Obstetrics, 16th ed. The fetus is in a left occiput anterior position. What follows is a description of these maneuvers:įig. The accuracy of Leopold's maneuvers can be hampered by the maternal body habitus, the presence of uterine fibroids, multiple gestations, or polyhydramnios. Through use of Leopold's maneuvers, a clinical estimate of the fetal weight also can be obtained, although this is not a formal part of this examination. In addition, a clinical estimate of the degree of engagement of the presenting part could be made, although the final determination of engagement must be made by way of a vaginal examination. The examiner may be able to palpate the presenting part. Leopold's maneuvers 1 consist of an abdominal examination divided into four steps of palpation of the gravid uterus and fetus (Fig. The obstetrician should be able to determine the fetal lie, presentation, and position, using the maternal vertebral column and pelvis as reference points, by Leopold's maneuvers, vaginal examination, and if necessary, ultrasound.
To assess the potential impact of the fetus on the characteristics of the labor process, it is important that the obstetrician be knowledgeable of the basic concepts used routinely to describe how the body of the fetus is located in the uterus.
