Accuracy of Leopold maneuvers in screening for malpresentation: a prospective study

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Fetal malpresentation occurs in 4-15% of pregnancies.
• Accurate and accessible screening methods are crucial for timely intervention.

Purpose of the Study:

• To evaluate the diagnostic accuracy of Leopold maneuvers for fetal malpresentation.
• To assess the utility of Leopold maneuvers as a screening tool in diverse clinical settings.

Main Methods:

• Prospective study involving 150 pregnant women.
• Fetal presentation determined by Leopold maneuvers performed by certified nurse-midwives.
• Ultrasound examination used as the gold standard for comparison.

Main Results:

• High sensitivity (88%) and specificity (94%) for Leopold maneuvers.
• Positive predictive value of 74% and negative predictive value of 97%.
• Effective in a population with a 17% fetal malpresentation rate.

Conclusions:

• Leopold maneuvers are an accurate screening tool for fetal malpresentation.
• Experienced clinicians can reliably perform these maneuvers.
• Particularly valuable in resource-limited settings lacking ultrasound availability.