Leopold's manoeuvres. Prior to listening for the fetal heart, you need to identify fetal position and
presentation using Leopold's maneuvers. Wash your hands before doing Leopold's and explain to the mother what you are doing.
For the first manoeuvre, face the mother and palpate the upper abdomen with both hands. Note the shape,
consistency and mobility of the palpated part.
The fetal head is firm hard and round and moves independently of the trunk.
The breach or buttocks feel softer and moves with the trunk.
To begin the second manoeuvre, move the hands down towards the pelvis and palpate the abdomen with gentle, but firm deep pressure.
The fetal back on one side of the abdomen feels smooth.
This is the area that provides the most audible fetal heart sounds.
On the opposite side, the fetal limbs feel knobby and bumpy.
For the third manoeuvre, place one hand just above the symphysis note whether the palpated part feels like the fetal head
or the breach,
And whether the presenting part is engaged.
To begin the fourth and last manoeuvre, face the mothers' feet.
Place both hands on the lower abdomen and move the fingers of both hands gently down the sides of the uterus towards the pubis.
Note the cephalic prominence or brow on the opposite side of the fetal back.
