Disconfort and impact of Kristeller’s Maneuver on women’s pelvic floor
DOI:
https://doi.org/10.29352/mill0215e.34588Keywords:
obstetric delivery; labour; obstetric complications; Kristeller ManoeuvreAbstract
Introduction: The Kristeller Manoeuvre, or pressure on the uterine fundus during the second stage of labour, is often used without the consent of the parturient woman and, due to its adverse effects, is considered obstetric violence.
Objective: To identify the relationship between the discomfort related to pelvic floor dysfunctions and its impact on the pelvic floor due to the use of Kristeller’s Maneuver in the second stage of labor.
Methods: Quantitative, relational-analytical, cross-sectional cohort study carried out with a non-probability convenience sample, according to the snowball method. Data was collected through an online questionnaire of 275 women who had given birth in Portugal in the last 5 years. Data were obtained on obstetric history, assessment of discomfort related to pelvic floor dysfunctions and their impact, and their relationship with sociodemographic factors of the sample and with data on the last delivery.
Results: Most women had only 1 full-term delivery (73.5%). Women whose last delivery was eutopic prevailed. Almost all of the sample had a simple birth, lasting less than 24 hours. More than half of the women reported having undergone episiotomy. In 50.9% of the cases, women were submitted to Kristeller Maneuver, and these had a greater impact on the pelvic floor.
Conclusion: It has been shown that the more bladder impact as a result of Kristeller’s Maneuver, the more urinary problems women report; the more bladder and vagina/perineal impact, the more pelvic floor problems, and the more bladder impact as a result, the more discomfort related to pelvic floor dysfunction women report.
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Arouca, M. A. F., Duarte, T. B., Lott, D. A. M., Magnani, P. S., Nogueira, A. A., Rosa-e-Silva, J. C., & Brito, L. G. O. (2016). Validation and cultural translation for Brazilian Portuguese version of the Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20). International Urogynecology Journal, 27(7), 1097–1106. https://doi.org/10.1007/s00192-015-2938-8
Becerra-Chauca, N., & Failoc-Rojas, V.E. (2019). Maniobra Kristeller, consecuencias físicas y éticas según sus protagonistas. Revista Cubana de Obstetricia Ginecología 45(2), e331, 1-13.
Carvalho, P. (2022). Violência obstétrica: práticas não recomendadas pela OMS com taxas em Portugal acima da média europeia. https://www.publico.pt/2022/02/10/sociedade/noticia/violencia-obstetrica-praticas-nao-recomendadas-oms-taxas-portugal-acima-media-europeia-1994855
Costa, R., Barata, C., Dias, H., Rodrigues, C., Santos, T., Mariani, I., Covi, B., Valente, E. P., Lazzerini, M., & Group, Ima. E. (2022). Regional differences in the quality of maternal and neonatal care during the COVID-19 pandemic in Portugal: Results from the IMAgiNE EURO study. International Journal of Gynecology & Obstetrics, 159(S1), 137–153. https://doi.org/10.1002/ijgo.14507
Cuerva, M. J., Tobias, P., Espinosa, J. A., & Bartha, J. L. (2015). Intrapartum ultrasound prior to Kristeller maneuver: An observational study. Journal of Perinatal Medicine, 43(2), 171–175. https://doi.org/10.1515/jpm-2014-0079
Leal, C., Pereira, A., Domingues, R., Filha, M., Dias, M., Nakamura-Pereira, M., Bastos, M. H., & Gama, S. (2014). Intervenções obstétricas durante o trabalho de parto e parto em mulheres brasileiras de risco habitual. Cadernos de Saúde vol.30,13 (suplemento 1). https://doi.org/10.1590/0102-311X00151513
Farrington, E., Connolly, M., Phung, L., Wilson, A. N., Comrie-Thomson, L., Bohren, M. A., Homer, C. S. E., & Vogel, J. P. (2021). The prevalence of uterine fundal pressure during the second stage of labour for women giving birth in health facilities: A systematic review and meta-analysis. Reproductive Health, 18(1), 98. https://doi.org/10.1186/s12978-021-01148-1
Hasegawa, J., Sekizawa, A., Ishiwata, I., Ikeda, T., & Kinoshita, K. (2015). Uterine rupture after the uterine fundal pressure maneuver. Journal of Perinatal Medicine, 43(6), 785–788. https://doi.org/10.1515/jpm-2014-0284
Hofmeyr, G. J., Vogel, J. P., Cuthbert, A., & Singata, M. (2017). Fundal pressure during the second stage of labour. The Cochrane Database of Systematic Reviews, 3(3), CD006067. https://doi.org/10.1002/14651858.CD006067.pub3
Malvasi, A., Zaami, S., Tinelli, A., Trojano, G., Montanari Vergallo, G., & Marinelli, E. (2019). Kristeller maneuvers or fundal pressure and maternal/neonatal morbidity: Obstetric and judicial literature review. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 32(15), 2598–2607. https://doi.org/10.1080/14767058.2018.1441278
Masuda, C., Ferolin, S. K., Masuda, K., Smith, C., & Matsui, M. (2020). Evidence-based intrapartum practice and its associated factors at a tertiary teaching hospital in the Philippines, a descriptive mixed-methods study. BMC Pregnancy and Childbirth, 20(1), 78. https://doi.org/10.1186/s12884-020-2778-5
Mena-Tudela, D., Iglesias-Casás, S., González-Chordá, V. M., Cervera-Gasch, Á., Andreu-Pejó, L., & Valero-Chilleron, M. J. (2020). Obstetric Violence in Spain (Part II): Interventionism and Medicalization during Birth. International Journal of Environmental Research and Public Health, 18(1), 199. https://doi.org/10.3390/ijerph18010199
Moiety, F. M. S., & Azzam, A. Z. (2014). Fundal pressure during the second stage of labor in a tertiary obstetric center: A prospective analysis. The Journal of Obstetrics and Gynaecology Research, 40(4), 946–953. https://doi.org/10.1111/jog.12284
Nascimento, K. I. M., Lima, V. de S., Novaes, C. D. P., Ponte, A. R., e Cardoso, L. R. C., de Aragão, C. R. B., Alcântara, L. da M., Pinheiro, R. M. A., Trindade, G. B. de M., & Brito, D. M. da S. (2021). Manobra de Kristeller: uma violência obstétrica. Brazilian Journal of Health Review, 4(2), 7362–7380. https://doi.org/10.34119/bjhrv4n2-278
Peterson, T. V., Pinto, R. A., Davila, G. W., Nahas, S. C., Baracat, E. C., & Haddad, J. M. (2019). Validation of the Brazilian Portuguese version of the pelvic floor bother questionnaire. International Urogynecology Journal, 30(1), 81–88. https://doi.org/10.1007/s00192-018-3627-1
Peyman, A., Shishegar, F., & Abbasi, Z. (2011). Uterine Fundal Pressure on the Duration of the Second Stage of Labor in Iran: A Randomized Controlled Trial. Journal of Basic Applied Scientific Research 1(11), 1930-1933. https://abrir.link/HUAPX
Rodrigues, D. P., Alves, V. H., Silva, A. M. e, Penna, L. H. G., Vieira, B. D. G., Silva, S. É. D. da, Reis, L. C. dos, & Branco, M. B. L. R. (2022). Women’s perception of labor and birth care: Obstacles to humanization. Revista Brasileira de Enfermagem, 75, e20210215. https://doi.org/10.1590/0034-7167-2021-0215
Royal College of Obstetricians and Gynaecologists (2012). Shoulder Dystocia (Green-top Guideline No. 42). RCOG. https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/shoulder-dystocia-green-top-guideline-no-42/
World Health Organization (2018). Intrapartum care for a positive childbirth experience. World Health Organization. http://apps.who.int/iris/bitstream/10665/260178/1/9789241550215-eng.pdf?ua=1%0Ahttp://www.who.int/reproductivehealth/publications/intrapartum-care-guidelines/en/
Youssef, A., Salsi, G., Cataneo, I., Pacella, G., Azzarone, C., Paganotto, M. C., Krsmanovic, J., Montaguti, E., Cariello, L., Bellussi, F., Rizzo, N., & Pilu, G. (2019). Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 53(1), 95–100. https://doi.org/10.1002/uog.19085
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