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Fundal pressure during the second stage of labour

Evelyn C Verheijen, Joanna H Raven, G Justus Hofmeyr
BACKGROUND: Fundal pressure during the second stage of labour involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal in an attempt to assist spontaneous vaginal delivery and avoid prolonged second stage or the need for operative delivery. Fundal pressure has also been applied using an inflatable girdle. A survey in the United States found that 84% of the respondents used fundal pressure in their obstetric centres.There is little evidence to demonstrate that the use of fundal pressure is effective to improve maternal and/or neonatal outcomes...
2009: Cochrane Database of Systematic Reviews
Sangeeta K Mishra, Norman Morris, Dhruba Kumar Uprety
BACKGROUND: Although ruptured uterus is nowadays a rare obstetric emergency in Western countries, it is still alarmingly common in developing countries, where it remains a major cause of maternal mortality and morbidity. AIMS: To review the recent experience of uterine rupture at a tertiary obstetric unit in eastern Nepal and to recommend improvements in the current management of labour, especially obstructed labour, in a poorly resourced country. METHODS: All cases of uterine rupture managed from March 2002 to March 2006 were identified retrospectively, and details were retrieved from medical records...
December 2006: Australian & New Zealand Journal of Obstetrics & Gynaecology
Catalin S Buhimschi, Irina A Buhimschi, Andrew M Malinow, Jerome N Kopelman, Carl P Weiner
OBJECTIVE: To investigate the relationship between intrauterine pressure and the application of a standardised fundal pressure manoeuvre, and to determine the maternal, fetal and labour characteristics that modulate the relationship. DESIGN: Prospective measurement of intrauterine pressure during the second stage of labour. SETTING: North American university hospital. POPULATION: Forty full-term women in spontaneous labour were studied during the second stage...
May 2002: BJOG: An International Journal of Obstetrics and Gynaecology
J Cox, C S Cotzias, O Siakpere, F I Osuagwu, E P Holmes, S Paterson-Brown
OBJECTIVE: To assess whether an inflatable obstetric belt, synchronised to apply uniform fundal pressure during a uterine contraction, reduces operative delivery rates when used in the second stage of labour. DESIGN: Randomised controlled trial. METHODS: Five hundred nulliparae with a singleton cephalic pregnancy at term and with an epidural in labour were recruited during the first stage and randomised at full dilatation. Standard care involved one hour passive second stage and one hour active pushing after which instrumental delivery was performed if delivery was not imminent...
December 1999: British Journal of Obstetrics and Gynaecology
D C Cumming, P J Taylor
Acute puerperal inversion of the uterus is considered to be rare. In one institution there were nine cases during an 11-year period, a rate of one for every 2176 vaginal deliveries. Analysis of these cases failed to identify any contributing factors occurring during the first or second stage of labour. Six cases were directly attributable to failure to administer an oxytocic preparation or, particularly, failure to await uterine contraction before attempting to expel the placenta by fundal pressure or cord traction...
May 20, 1978: Canadian Medical Association Journal
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