Aim:The aim of this prospective randomized clinical case study isthe comparison between two different ways, to perform fundalpressure (Kristeller’s expression), during the second stage oflabour, in low-risk women.Methods:The manoeuvre has been performed by the sameoperator (RA) for delay of the progression of the fetal head, withhead visible during the contractions. A bedside ultrasoundexaminations to determine fetal position Was executed. We alsodetermined the fetal position at delivery. This study included 102patients, that delivered in maternity department of Niguardahospital between January 2000 and December 2007. Informedconsent was obtained from every participant.Results:At the time of the onset of fundal pressure in 48 patientsfetal position of the head was in Left Occiput Anterior (LOA).These patients were randomised into two groups: in group A (24cases), the pressure was applied by the right side of the patient; inthe group B (24 cases), On the contrary, the pressure wasperformed by the patient left side. The average of Kristeller’sexpression necessary to carry out the birth in group A was one,versus two in group B (P< 0, 05). In 32 cases fetal position ofthe head was in Right Occiput Anterior (ROA), also these patientswere randomised into two groups: in group A (17 cases), thepressure was performed by the patient left side in the other 15cases, the pressure was executed by the right side of the patients.The average of Kristeller’s expression, necessary to carry out thebirth, in group A was one versus three in group B (P< 0.05). Allother fetal positions, 22 patients, were excluded from the presentstudy.Conclusion:This manoeuvre, should be reserved for the rare andstrictly indicated cases, However, if obstetrician decide that fundalpressure is necessary, it must be done in the most correct way,driven the pressure by the left side of the patient when the fetalHead is in ROA and driven the pressure by the right side of thepatient when the fetal haed is in LOA.
Fundal pressure and second stage of labour, whichdirection is the best direction?
A. Ragusa;
2012-01-01
Abstract
Aim:The aim of this prospective randomized clinical case study isthe comparison between two different ways, to perform fundalpressure (Kristeller’s expression), during the second stage oflabour, in low-risk women.Methods:The manoeuvre has been performed by the sameoperator (RA) for delay of the progression of the fetal head, withhead visible during the contractions. A bedside ultrasoundexaminations to determine fetal position Was executed. We alsodetermined the fetal position at delivery. This study included 102patients, that delivered in maternity department of Niguardahospital between January 2000 and December 2007. Informedconsent was obtained from every participant.Results:At the time of the onset of fundal pressure in 48 patientsfetal position of the head was in Left Occiput Anterior (LOA).These patients were randomised into two groups: in group A (24cases), the pressure was applied by the right side of the patient; inthe group B (24 cases), On the contrary, the pressure wasperformed by the patient left side. The average of Kristeller’sexpression necessary to carry out the birth in group A was one,versus two in group B (P< 0, 05). In 32 cases fetal position ofthe head was in Right Occiput Anterior (ROA), also these patientswere randomised into two groups: in group A (17 cases), thepressure was performed by the patient left side in the other 15cases, the pressure was executed by the right side of the patients.The average of Kristeller’s expression, necessary to carry out thebirth, in group A was one versus three in group B (P< 0.05). Allother fetal positions, 22 patients, were excluded from the presentstudy.Conclusion:This manoeuvre, should be reserved for the rare andstrictly indicated cases, However, if obstetrician decide that fundalpressure is necessary, it must be done in the most correct way,driven the pressure by the left side of the patient when the fetalHead is in ROA and driven the pressure by the right side of thepatient when the fetal haed is in LOA.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
