Leopold\'s maneuver.txt

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Leopold\'s maneuver.txt
2012-07-19 19:36:03
pn 135 prenatal leopold maneuver

Leopold's maneuver
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  1. must be 24 weeks gestation.
    Instruct woman to empty her bladder first
  2. Place woman in dorsal recumbent position, supine with knees flexed to relax abdominal muscles
    Place a small pillow under the head for comfort.
  3. Drape properly to maintain privacy.
    Explain procedure to the patient.
  4. Warms hands by rubbing together. (Cold hands can stimulate uterine contractions).
    Use the palm for palpation not the fingers.
  5. First Maneuver:

  6. fundal grip - purpose?
    • placement
    • determine presentation, what part of the fetus is in the fundus
  7. Placement: procedure
    • both hands
    • feel for the part of the fetus that is in the fundus
  8. Placement:  findings
    • head:  firm, round, moves independently from the trunk
    • breech:  less defined, moves with the trunk
  9. second maneuver

  10. umbilical grip:pu  rpose?
    • lie
    • determine position, where is the fetal back
  11. Lie:  procedure
    • one hand on each side
    • feel for the back and small fetal parts
    • move in circular motions from top to bottom
  12. Lie:  findings
    • fetal back: smooth, hard, resistant surface
    • fetal knees and elbows:  several angles
  13. third maneuver

  14. Engagement:  purpose?
    • engagement
    • to determine the presenting part
  15. Engagement:  procedure
    • use thumb and forefinger
    • grasp above the symphisis pubis
    • press slightly, move from side to side
  16. Engagement:  findings
    • moveable:  not engaged
    • not moveable:  engaged
  17. Fourth procedure

  18. Attitude:  purpose?
    determine the attitude of the fetus
  19. Attitude:  procedure
    • face foot of bed
    • use both hands
    • palpate head, pressing down
  20. Attitude:  findings
    chin towards chest or looking up