Leopold Manouvres

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Definition

-  Systematic assessment of the gravid uterus to determine fetal position during pregnancy

 

Features

-  Difficult in obese women or polyhyrdramnios

-  Can be uncomfortable for woman

-  4 different manouvres/grips

 

Indications

-  Pregnancy

-  Labour

 

Procedure

-  +/- empty bladder

-  Patient supine

-  Abdomen exposed

-  Fundal Grip

-  Attempt to identify fetal part in fundus

-  Face towards womans head

-  Palpate uterine fundus w both hands

-  Umbilical Grip

-  Attempt to identify fetal back

-  Face towards womans head

-  Deep pressure w both palms

-  Stabilise w right examine w left

-  Stablise w left examine w right

-  Pawlicks Grip

-  Attempt to identify fetal presenting part

-  Grasp abdomen immediately superior to pubic symphysis between thumb & fingers

-  Pelvic Grip

-  Attempt to identify fetal brow (if cephalic)

-  Face towards womans feet

-  Move fingers of both hands down uterus towards pubic sympyhsis

-  +/- confirm findings w US as required

 

 

 

 

References

 

www.fpnotebook.com/ob/exam/LpldsMnvrs.htm

Pic: http://upload.wikimedia.org/wikipedia/commons/e/eb/Handgriffe.JPG