Utility of Leopold maneuvers in screening for malpresentation.

Malpresentation is a common complication of pregnancy. Using ultrasound as the gold standard, we prospectively tested Leopold maneuvers as a screen for nonvertex presentation in the third trimester. In our hands this technique performed poorly. Values for sensitivity, specificity, positive predictive value, and negative predictive value were 28, 94, 24, and 95%, respectively, in a population with a 7% prevalence of noncephalic presentation. Much of the correlation between the screening and diagnostic tests seemed to arise from chance (kappa = 0.13).