ABSTRACT
From December 1996 to February 1997 a total of 310 pregnant women at term who attended antenatal care clinic at Siriraj Hospital underwent abdominal examination using Leopold maneuvers by the first year resident physicians on duty. Then they were reexamined using ultrasonography by the staff physicians in ultrasound clinic without prior knowledge of the results of previous abdominal examinations. Compared with the ultrasonographic results, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false positive rate and false negative rate of Leopold maneuvers in screening for malpresentation in pregnant women at term were 96.8, 66.7, 98.3, 66.7, 98.3, 1.6 and 1.6 percent respectively. The use of Leopold maneuvers for diagnosis of malpresentation has limit sensitivity. However, it is appreciably specific for diagnosis of normal fetal presentation. In conclusion, all cases of fetal malpresentation diagnosed by Leopold maneuvers should be further examined by other methods for specific diagnosis.