It is a systematic method of observation and palpation that lets the health practitioner determine the position of the baby inside the motherís womb. It gets more accurate the closer the mother is to her labor and delivery stage.
Leopoldís Maneuver is difficult to perform on mothers who may appear to be too big or obese. It may be uncomfortable for mothers with a full bladder to go on with Leopoldís Maneuver, so it is crucial that she empties them first before carrying on with the procedure.
She also needs to lie on her back while knees are flexed slightly so that the abdomen will be relaxed during the procedure. Try to put pillows on her back to slightly raise her shoulders. And also do not forget to use gentle but firm touch using the palm of your hands during the procedure.
The first maneuver will let you find the fetal head. Place palms on each side of the abdomen and palpate. The fetal head should feel firm, round and hard that is moving independently with the body. If the buttocks is in the fundus you well feel a soft irregular shape that is difficult to move. This is termed as breech.
The second maneuver lets you look for the back of the baby. Dominant hand should remain on one side as the non-dominant hand explores the right side of the uterus. This is repeated using the opposite side and hands. Fetal back should feel hard, smooth and should have a resistant surface. Knees and Elbows of the baby will feel like a number of protrusions and angular nodulations.
Third maneuver lets you determine if the baby is settled firmly in the pelvis or not. Grasp the lower portion of the abdomen using your thumb and fingers, press lightly and make gentle movements from side to side. If it is movable, then the fetus is not yet engaged (settled firmly). If it is no longer movable, then that means the head of the baby is already tight up your cervix, and birthing process is almost ready to start.
Fourth Maneuver lets you determine the degree of flexion of the fetus. It requires the health provider to face the foot of the woman, put fingers on both sides of the uterus, and press down and inward. If your fingers do not meet any obstruction, then you are now palpating the fetal neck. As the fingers of the other hand meet an obstruction above the ligament palpates the fetal brow. The baby is in good flexion if brow corresponds to the side (2nd) that contains the elbows and knees. Babyís neck may be hyperextended if fingers meet an obstruction on the same side at the fetal back.
We should caution the fact that Leopoldís Maneuver should be done by health care professionals, or to those who have undergone training regarding the procedure. Nevertheless, as long as you perform the procedure safely and correctly doing it at home is okay.