Leopold's maneuvers

The Leopold- handles, named after the gynecologist Christian Leopold (1846-1911), belong to the physical examination of a woman during pregnancy. In conjunction with other clinical and instrumental investigations (eg, vaginal examination, ultrasonography ) and used to estimate a timely Pregnancy and for determining the position of the fetus in the womb. All Leopold handles provide a palpation through the abdominal wall and is performed on the supine patient.

1 Leopold Handle: Determination of the fundus prior

With both hand edges - starting at the rib cage - trying to feel the fundus status of the uterus. In the later course of pregnancy (late second and third trimester ) the position of the fetus can be determined. So can eg breech of the child's head buttons in the fundus.

2 Leopold Handle: Location of the back and small parts

To determine the position of the child's back, the hands are applied to the left and right of the palpable uterus. Slight pressure limbs (small parts) on one side and the back can be sensed on the other side.

• I mean: back is to the left (in each case as seen from the woman )
• II means back is to the right.
• I / IIa each represents: Trend forward,
• I / IIb according to trend backwards.

In transverse position, this refers to the position of the fetal head.

3 Leopold Handle: Determination of the preceding part

He used to determine the position of the fetus, that is, whether head or breech present. For this purpose, the examiner places his hand on above the symphysis and tried with thumb and forefinger the skull of the child back and forth to push ( ' ballotieren '). If the child is in breech presentation, this is not possible.

4 Leopold Handle: Determination of setting

It is used to feeling the setting ( ie the positional relationship of the presenting part to the pelvic inlet ) of the child after it has already entered something into the pool. The examiner leaves his fingertips slowly coming up from lateral parallel to the bar above the abdominal wall to slide into the pool. Thus, the type ( head or legs) and position of the presenting part to be assessed in relation to the pelvic inlet.

5 Leopold-Handgriff/Zangemeister-Handgriff: exclusion of a disproportion between the pelvis and head

(also: Zangemeister handle, named after Wilhelm Zangemeister ) The Zangemeister handle is used during labor the detection of a mismatch between the maternal pelvis and childlike head, for example, at high Geradstand. For this, the examiner places one hand on the pubic symphysis and the other cranial them to the preceding part of the child. Here, the cephalad hand should be on a lower level than the caudal. If this is not the case, it throws suspicion on a disproportion between the pelvis and the child.