Introduction
It has been advised by some authors that uterine fundal pressure maneuver (UFPM) be applied with a steady, gentle pressure with one open hand on the fundus of the uterus at a 30º to 40º angle to the maternal spine in the direction of the cervix during the second stage of labor [1]. UFPM has been performed to assist the terminal phase of vaginal delivery through increasing the intrauterine pressure [1, 2]; however it has been a controversial maneuver. UFPM applied under well-controlled condition significantly increases intrauterine pressure in some, but not all women, and it has been supposed to be able to avoid unnecessary or delayed operative intervention [2]. However, some recent reviews have documented that no confirmed beneficial or harmful effects of use of UFPM [1, 3]. In these reviews, in addition, there has been insufficient evidence regarding safety of UFPM for the baby although the adverse influences on the maternal perineum have been inconclusive [1, 3]. However, some case reports have investigated adverse events associated with inadequate use of the maneuver such as uterine rupture [4, 5], rib rupture [6], anal sphincter tears [7] and amniotic fluid embolism [8]. The reasons leading these events are unclear, because some authors have thought that other factors than UFPM such as episiotomy and vacuum extraction are associated with these adverse events [1, 3, 9, 10]. Therefore, the prognosis of deliveries with UFPM has been attributed to a variety of other factors than UFPM.
In this study, therefore, we examined the patient characteristics and obstetrical outcomes of deliveries with UFPM to identify their clinical significance at our hospital: Japanese Red Cross Katsushika Maternity hospital, one of perinatal center in Tokyo, Japan.
IntroductionIt has been advised by some authors that uterine fundal pressure maneuver (UFPM) be applied with a steady, gentle pressure with one open hand on the fundus of the uterus at a 30º to 40º angle to the maternal spine in the direction of the cervix during the second stage of labor [1]. UFPM has been performed to assist the terminal phase of vaginal delivery through increasing the intrauterine pressure [1, 2]; however it has been a controversial maneuver. UFPM applied under well-controlled condition significantly increases intrauterine pressure in some, but not all women, and it has been supposed to be able to avoid unnecessary or delayed operative intervention [2]. However, some recent reviews have documented that no confirmed beneficial or harmful effects of use of UFPM [1, 3]. In these reviews, in addition, there has been insufficient evidence regarding safety of UFPM for the baby although the adverse influences on the maternal perineum have been inconclusive [1, 3]. However, some case reports have investigated adverse events associated with inadequate use of the maneuver such as uterine rupture [4, 5], rib rupture [6], anal sphincter tears [7] and amniotic fluid embolism [8]. The reasons leading these events are unclear, because some authors have thought that other factors than UFPM such as episiotomy and vacuum extraction are associated with these adverse events [1, 3, 9, 10]. Therefore, the prognosis of deliveries with UFPM has been attributed to a variety of other factors than UFPM. In this study, therefore, we examined the patient characteristics and obstetrical outcomes of deliveries with UFPM to identify their clinical significance at our hospital: Japanese Red Cross Katsushika Maternity hospital, one of perinatal center in Tokyo, Japan.
การแปล กรุณารอสักครู่..
