The Outcomes of Delivery by Fundal Pressure Maneuver in the Second Stage of Labor

Asti, Parvin; Changaee, Farahnaz; PirdadehBeiranvand, Sohila; Beiranvand, Shorangiz

doi:10.22087/ijac.2020.125327

The Outcomes of Delivery by Fundal Pressure Maneuver in the Second Stage of Labor

Document Type : Research

Authors

Parvin Asti

Farahnaz Changaee

Sohila PirdadehBeiranvand

Shorangiz Beiranvand

Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran

10.22087/ijac.2020.125327

Abstract

The use of uterine fundal pressure maneuver to assist pregnant women in the second stage of labor is a controversial issue. Therefore, the aim of this study is to detect the outcomes of delivery by fundal pressure in the second stage of labor. In this cross-sectional study, 166 women with uterine fundal pressure maneuver and 165 samples without uterine fundal pressure maneuver were delivered. Then, delivery outcome was evaluated in two groups. The results showed that the mean amounts of postpartum hemorrhage of the first 30 min were 681.144(385.2), and 280.2(377.87) in with uterine fundal pressure maneuver and without uterine fundal pressure maneuver groups, respectively. Frequency of episiotomy was in the with uterine fundal pressure maneuver group 21.7% and 1.2% in without uterine fundal pressure maneuver groups. The mean Apgar score in the first minute (7.66 ± 1.07 and 8.63 ± 0.93) and fifth (9.74 ± 0.61 and 9.92.0 ± 0.65) delivery in with uterine fundal pressure maneuver of without uterine fundal pressure maneuver groups was significantly lower, respectively (p<0.001). Rate of infants admitted in neonatal intensive care unit in with uterine fundal pressure maneuver groups was 28.3% and without uterine fundal pressure maneuver groups was 4.9%, respectively: The use of uterine fundal pressure maneuver increased the rate of maternal and neonatal complications. Therefore, physicians and midwives should make the decision about the appropriate use of uterine fundal pressure maneuver based on the patient's individual clinical circumstances.

Keywords

Fundal pressure maneuver

Outcomes

Delivery

Second stage of labor

the management of the second stage of labor: a reappraisal. Obstetrical & gynecological survey. 2005;60(9):599-603.
2. Habek D, VukovićBobić M, Hrgović Z. Possible feto-maternal clinical risk of the Kristeller’s expression. Open Medicine. 2008;3(2):183-6.
3. Tongate S, Gibbs JD. Nurses, Physicians and disagreements about fundal Pressure. Nursing for women's health 2010; 14(2):137-42.
4. Matsuo K, Shiki Y, Yamasaki M, Shimoya K. Use of uterine fundal pressure maneuver at vaginal delivery and risk of severe perineal laceration. Archives of gynecology and obstetrics. 2009; 280(5):781-6.
5. Simpson KR, Knox GE. Fundal pressure during the second stage of labor: Clinical perspectives and risk management issues. MCN: The American Journal of Maternal/Child Nursing. 2001; 26(2):64-71.
6. Simpson KR, Knox GE. Common areas of litigation related to care during labor and birth: Recommendations to promote patient safety and decrease risk exposure. The Journal of perinatal & neonatal nursing. 2003; 17(2):110-25.
7. Palmer J. Physiological pushing in the second stage of labour: The future for midwifery care. Australian College of Midwives Incorporated Journal. 1996; 9(3):15-20.
8. Verheijen EC, Raven JH, HofmeyrGJ. Fundal pressure during the second stage of labour. The Cochrane Library. 2009.
9.Buhimschi CS, Buhimschi IA, Malinow AM, KopelmanJN, Weiner CP. The effect of fundal pressure manoeuvre on intrauterine pressure in the second stage of labour. BJOG: An International Journal of Obstetrics &Gynaecology. 2002; 109(5):520-6.
10. Tukur J, Omale A, Abdullahi H, Datti Z. Uterine prolapse following fundal pressure in the first stage of labour: a case report. Annals of African medicine. 2007; 6(4).
11. Murphy PA, CosnerKKR. Use oF fundal pressure during second‐stage labor. A pilot study. Journal of nurse-midwifery. 1996; 41(4):334-7.
12. Flamm BL. Shoulder dystocia and fundal pressure: A medical legal dilemma. Journal of Healthcare Risk Management. 2002; 22(2):9-14.
13. Greenwald LM, Mondor M. Malpractice and the perinatal nurse. The Journal of perinatal & neonatal nursing. 2003; 17(2):101-9.
14. Mahendru R, Malik S, Anand T. Age old practice of uterine fundal pressure in labor-more risky than beneficial. Biomedical Research. 2010; 21(3):295-6.
15. Shimada M, Suzuki S. Clinical significance of deliveries with uterine fundal pressure maneuver at a single perinatal center in Japan. Journal of Clinical Gynecology and Obstetrics. 2013; 2(1):10-4.
16. Odd DE, Rasmussen F, Gunnell D, Lewis G, Whitelaw A. A cohort study of low Apgar scores and cognitive outcomes. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2008; 93(2):F115-F20.
17. Roberts J, Hanson L. Best practices in second stage labor care: maternal bearing down and positioning. Journal of Midwifery and Women’s Health. 2007; 52(3):238-45.
18. Ibrahimzadehzagami S, Aghazadeh A. The outcome of delivery by fundal Pressure in the second stage of labor with spontaneous delivery. Journal of Mashhad School of Nursing and Midwifery.2009; 9(1): 37-44.
19. Gennaro S, Mayberry LJ, Kafulafula U. The evidence supporting nursing management of labor. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2007; 36(6):598-604.