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Leopold’s Maneuvers

Other known aliases – Leopold-Handgrïff

Definition – Series of four distinct actions to systematically determine the lie and position of the fetus in utero:

• First Maneuver – Fundal Grip
  • used to locate fetal position (breech vs vertex)

• Second Maneuver – Umbilical Grip
  • used to locate the back of the fetus

• Third Maneuver – Second Pelvic Grip
  • used to determine pelvic inlet position

• Fourth Maneuver – First Pelvic Grip
  • used to locate the fetal brow

Clinical Significance – These are now an antiquated way to determine fetal positioning to predict difficult deliveries or need for cesarean section. These have largely been replaced by obstetrical ultrasound.

History – Named after Christian Gerhard Leopold (1846-1911), who was a German gynecologist and received his medical doctorate from the University of Leipzig in 1870. He spent the early part of his career teaching midwifery at the Frauenklinik in Leipiz before taking a professorship at the University of Leipzig in 1883. Later that same year, he took over as the Director of the Dresden Royal Gynaecological Infirmary and by the end of his tenure developed it into a leading hospital in Germany. He published his eponymous maneuvers in several articles (first in 1894) in the journal Archiv für Gynäkologie, for which he was a co-editor.

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References

• Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
• Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
• Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
• Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
• Up To Date. www.uptodate.com
• Leopold CG – Die Leitung der regelmäßigen Geburt nur durch äußere Untersuchung. Arch Gynäkol. 1894; 45: 337–368
• Kästner I, Kachlík D. German gynecologist and obstetrician Christian Gerhard Leopold (1846-1911). Ceska gynekologie. 2010; 75(3):218-21. [pubmed]