When performing Leopold’s maneuvers on a primigravid client, the nurse is palpating the uterus as shown below. Which of the following maneuvers is the nurse performing?
- First maneuver.
- Second maneuver.
- Third maneuver.
- Fourth maneuver.
The correct answer and explanation is :
The correct answer is:
2. Second maneuver.
Explanation:
Leopold’s maneuvers are a series of four distinct steps used by healthcare providers to assess the position, presentation, and lie of the fetus during pregnancy, particularly in the third trimester. They are performed to help determine the fetal position and facilitate the management of labor.
Here’s a breakdown of each of the four maneuvers:
- First Maneuver (Fundal Grip):
This maneuver involves palpating the upper part of the abdomen, or the fundus of the uterus, to determine the fetal part that occupies this region. The nurse attempts to determine if the head or the breech is in the fundus. If the head is palpable, it is firm and round, whereas the breech feels softer and irregular. - Second Maneuver (Umbilical Grip):
In this maneuver, the nurse moves their hands down both sides of the uterus to assess the sides of the fetal back and limbs. The goal is to locate the fetal back, which feels smooth and firm, and the limbs, which feel irregular and knobby. This step is used to determine whether the fetus is in a transverse, cephalic, or breech position. - Third Maneuver (Pawlik’s Grip):
This maneuver involves palpating just above the pubic symphysis to determine whether the presenting part is engaged in the pelvis. The nurse feels to determine whether the presenting part (typically the head or breech) is movable or fixed in the pelvis. - Fourth Maneuver (Pelvic Grip):
The final maneuver is performed to identify the location of the fetal head and determine if it is flexed or extended. It is used to determine the descent of the fetus and the relationship between the fetal head and the pelvic inlet.
Why the Second Maneuver is Correct:
In the scenario where the nurse is palpating the uterus and identifying the fetal parts, if the nurse is focusing on identifying the fetal back and limbs, they are performing the second maneuver. This is key for understanding the fetal position, as the nurse assesses which part of the fetus is in the anterior or posterior position.
