Pathophysiology
Clinical meaning
Leopold maneuvers are a systematic series of four abdominal palpation techniques used to determine fetal lie, presentation, position, and engagement in the maternal pelvis during the third trimester of pregnancy (typically performed after 28-30 weeks gestation when fetal parts become reliably palpable). These maneuvers provide critical information for birth planning, labor management, and identification of malpresentation. First maneuver (fundal grip): The nurse faces the patient's head and palpates the uterine fundus with both hands to determine which fetal pole occupies the fundus. The fetal buttocks (breech pole) feel broad, irregular, and soft; the fetal head (cephalic pole) feels round, firm, smooth, and ballottable (can be moved independently between the hands). If the head is at the fundus, the fetus is in breech presentation. Second maneuver (lateral/umbilical grip): The nurse maintains the same position and moves both hands to the lateral aspects of the uterus, stabilizing with one hand while palpating with the other. The fetal back feels as a smooth, continuous, firm, convex surface on one side. The fetal extremities (small parts) feel as multiple small irregular knobs and movements...