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Intrapartum ultrasound prior to Kristeller maneuver: an observational study

  • Marcos Javier Cuerva EMAIL logo , Pablo Tobias , Jose Angel Espinosa and Jose Luis Bartha
Published/Copyright: July 17, 2014

Abstract

Objectives: To evaluate the accuracy of criteria followed by obstetricians when performing a Kristeller maneuver in cases of prolonged second stage of labor.

Methods: In this prospective observational study, the station of the fetal head was measured using the angle of progression (intrapartum ultrasound) just prior to the intervention of the managing obstetrician in 52 women with prolonged second stage of labor. The managing obstetricians were blinded to the sonographic results. The decision of performing a Kristeller maneuver was taken by the obstetricians based on digital palpation and their experience. Delivery mode, Apgar score, umbilical artery pH value, episiotomy, perineal tears, bleeding, and time to delivery were recorded.

Results: Kristeller maneuver was performed in 36/52 (69.2%) cases. There were no significant differences between the Kristeller and the non-Kristeller group regarding the angle of progression. There were no significant differences between both groups with respect to delivery mode, perineal tears, episiotomy, bleeding, Apgar score, and umbilical artery pH value.

Conclusions: Our study failed to define any criteria followed by obstetricians when performing a Kristeller maneuver in cases of prolonged second stage of labor. There was no relation between the angle of progression and the decision to perform a Kristeller maneuver.


Corresponding author: Marcos Javier Cuerva, MD, Department of Obstetrics, Quiron San Jose Hospital, Cartagena, 111, 28002 Madrid, Spain, Tel.: +34 677026551, E-mail:

Acknowledgments

Santiago Balo (for the figures).

References

[1] Acanfora L, Rampon M, Filippeschi M, Marchi M, Montisci M, Viel G, et al. An inflatable ergonomic 3-chamber fundal pressure belt to assist vaginal delivery. Int J Gynaecol Obstet. 2013;120:78–81.10.1016/j.ijgo.2012.07.025Search in Google Scholar PubMed

[2] Api O, Balcin ME, Ugurel V, Api M, Turan C, Unal O. The effect of uterine fundal pressure on the duration of the second stage of labor: a randomized controlled trial. Acta Obstet Gynecol Scand. 2009;88:320–4.10.1080/00016340902730326Search in Google Scholar PubMed

[3] Barbera AF, Pombar X, Perugino G, Lezotte DC, Hobbins JC. A new method to assess fetal head descent in labor with transperineal ultrasound. Ultrasound Obstet Gynecol. 2009;33: 313–9.10.1002/uog.6329Search in Google Scholar PubMed

[4] Cuerva MJ, Bamberg C, Tobias P, Gil MM, De La Calle M, Bartha JL. Use of intrapartum ultrasound in the prediction of complicated operative forceps delivery of fetuses in non-occiput posterior position. Ultrasound Obstet Gynecol. 2014;43:687–92.10.1002/uog.13256Search in Google Scholar PubMed

[5] Dückelmann AM, Bamberg C, Michaelis SA, Lange J, Nonnenmacher A, Dudenhausen JW, et al. Measurement of fetal head descent using the “angle of progression” on transperineal ultrasound imaging is reliable regardless of fetal head station or ultrasound expertise. Ultrasound Obstet Gynecol. 2010;35:216–22.10.1002/uog.7521Search in Google Scholar PubMed

[6] Dupuis O, Silveira R, Zentner A, Dittmar A, Gaucherand P, Cucherat M, et al. Birth simulator: reliability of transvaginal assessment of fetal head station as defined by the American College of Obstetricians and Gynecologists classification. Am J Obstet Gynecol. 2005;192:868–74.10.1016/j.ajog.2004.09.028Search in Google Scholar PubMed

[7] Ghi T, Farina A, Pedrazzi A, Rizzo N, Pelusi G, Pilu G. Diagnosis of station and rotation of the fetal head in the second stage of labor with intrapartum translabial ultrasound. Ultrasound Obstet Gynecol. 2009;33:331–6.10.1002/uog.6313Search in Google Scholar PubMed

[8] Henrich W, Dudenhausen J, Fuchs I, Kämena A, Tutschek B. Intrapartum translabial ultrasound (ITU): sonographic landmarks and correlation with successful vacuum extraction. Ultrasound Obstet Gynecol. 2006;28:753–60.10.1002/uog.3848Search in Google Scholar PubMed

[9] Hoogsteder PH, Pijnenborg JM. Use of uterine fundal pressure maneuver at vaginal delivery and risk of severe perineal laceration. Arch Gynecol Obstet. 2010;281:579–80.10.1007/s00404-009-1229-3Search in Google Scholar PubMed PubMed Central

[10] Kalache KD, Dückelmann AM, Michaelis SA, Lange J, Cichon G, Dudenhausen JW. Transperineal ultrasound imaging in prolonged second stage of labor with occipitoanterior presenting fetuses: how well does the “angle of progression” predict the mode of delivery? Ultrasound Obstet Gynecol. 2009;33: 326–30.10.1002/uog.6294Search in Google Scholar PubMed

[11] Kline-Kaye V, Miller-Slade D. The use of fundal pressure during the second stage of labor. J Obstet Gynecol Neonatal Nurs. 1990;19:511–7.10.1111/j.1552-6909.1990.tb01670.xSearch in Google Scholar PubMed

[12] Merhi ZO, Awonuga AO. The role of uterine fundal pressure in the management of the second stage of labor: a reappraisal. Obstet Gynecol Surv. 2005;60:599–603.10.1097/01.ogx.0000175804.68946.acSearch in Google Scholar PubMed

[13] Molina FS, Terra R, Carrillo MP, Puertas A, Nicolaides KH. What is the most reliable ultrasound parameter for assessment of fetal head descent? Ultrasound Obstet Gynecol. 2010;36: 493–9.10.1002/uog.7709Search in Google Scholar PubMed

[14] Pignotti MS, Fiorini P, Donzelli G, Messineo A. Neonatal hemoperitoneum: unexpected birth trauma with fatal consequences. J Clin Neonatol. 2013;2:143–5.10.4103/2249-4847.120006Search in Google Scholar PubMed PubMed Central

[15] Sartore A, De Seta F, Maso G, Ricci G, Alberico S, Borelli M, et al. The effects of uterine fundal pressure (Kristeller maneuver) on pelvic floor function after vaginal delivery. Arch Gynecol Obstet. 2012;286:1135–9.10.1007/s00404-012-2444-xSearch in Google Scholar PubMed

[16] Sultan AH, Thakar R. Lower genital tract and anal sphincter trauma. Best Pract Res Clin Obstet Gyanecol. 2002;16:99–115.10.1053/beog.2002.0258Search in Google Scholar PubMed

[17] Torkildsen EA, Salvesen KÅ, Eggebø TM. Prediction of delivery mode with transperineal ultrasound in women with prolonged first stage of labor. Ultrasound Obstet Gynecol. 2011;37:702–8.10.1002/uog.8951Search in Google Scholar PubMed

[18] Tutschek B, Braun T, Chantraine F, Henrich W. A study of progress of labour using intrapartum translabial ultrasound, assessing head station, direction, and angle of descent. BJOG. 2011;118:62–9.10.1111/j.1471-0528.2010.02775.xSearch in Google Scholar PubMed

[19] Tutschek B, Torkildsen EA, Eggebø TM. Comparison between ultrasound parameters and clinical examination to assess fetal head station in labor. Ultrasound Obstet Gynecol. 2013;41:425–9.10.1002/uog.12422Search in Google Scholar PubMed

[20] Weerasekera DS, Premaratne S. A randomised prospective trial of the obstetric forceps versus vacuum extraction using defined criteria. J Obstet Gynaecol. 2002;22:344–5.10.1080/01443610220141227Search in Google Scholar PubMed

[21] Zetterström J, López A, Anzén B, Norman M, Holmström B, Mellgren A. Anal sphincter tears at vaginal delivery: risk factors and clinical outcome of primary repair. Obstet Gynecol. 1999;94:21–8.10.1097/00006250-199907000-00005Search in Google Scholar

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-3-4
Accepted: 2014-6-30
Published Online: 2014-7-17
Published in Print: 2015-3-1

©2015 by De Gruyter

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