Accuracy of Leopold maneuvers in screening for malpresentation: a prospective study.
This study describes the accuracy of Leopold maneuvers as a screening procedure for fetal malpresentation. The frequency of fetal malpresentation ranges from 15 percent at 32 weeks to 4 percent at term. We prospectively determined fetal presentation by performing Leopold maneuvers on 150 women, followed by a fetal ultrasound examination for comparison. Experienced certified nurse-midwives performed the maneuvers with high sensitivity (88%), specificity (94%), positive predictive value (74%), and negative predictive value (97%) in a population with a 17 percent frequency of fetal malpresentation. We conclude that the maneuvers used by experienced clinicians can be effective as a screening tool for fetal malpresentation, particularly in settings where ultrasound may not be readily available.
Lydon-Rochelle
M
M
Albers
L
L
Gorwoda
J
J
Craig
E
E
Qualls
C
C
D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007746:Labor Presentation; D008403:Mass Screening / Q000379:methods*; D009721:Nurse Midwives; D010173:Palpation / Q000379:methods*; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal