Possible feto-maternal clinical risk of the Kristeller’s expression

• Authors: Dubravko Habek , Mirna Vuković Bobić , Zlatko Hrgović
• Languages of publication: EN

Abstracts

EN

The aim of this clinical case study is evaluation of possible intrapartal complication of the uncritical Kristeller’s expression. In this retrospective clinical study, data on seven parturients with significant maternal or fetal intrapartum complications during the second labor stage and Kristeller expression, associated with the maneuver, were analyzed. Data was obtained from patient files: history of delivery delivery room protocol and neonatal reports from two tertiary maternal wards. There were five uterine ruptures that were treated by laparotomy and uterine sutures. Atypical rupture location on the uterine fundus occurred in one case, isthmus rupture in three cases, and rupture of the scar left after a previous cesarean section as a potential risk factor for uterine rupture in one case. Complex uterine cervicoisthmic rupture with incomplete colporrhexis occurred during the delivery of a macrosomic child at an outpatient ward. In one case, unilateral fracture of the tenth and eleventh ribs resolved spontaneously without complications. One case of peripartum trauma, possibly associated with extensive expression was observed in one neonates: cutaneous and subcutaneous hematoma on the back with traumatic unilateral adrenal hemorrhage. Both newborns were monitored, successfully treated, and discharged from the hospital free from complications. In conclusion, in the obstetrics as a high risk profession, a very critical approach should be exercised on choosing this maneuver, which should be reserved for the rare and strictly indicated cases, thereby strictly following the professional rules to avoid generally unnecessary and unpleasant litigation and forensic expertise.

Keywords

EN

Kristeller’s expression; Labour; Forensic; Obstetrics; Risk

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2008
• Volume: 3
• Issue: 2
• Pages: 183-186

Dates

published

1 - 6 - 2008

online

9 - 4 - 2008

Contributors

author

Dubravko Habek

• Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital, Zagreb, Croatia

author

Mirna Vuković Bobić

• Department of Obstetrics and Gynecology Clinical Hospital Osijek, Osijek, Croatia

author

Zlatko Hrgović

• Praxis für Geburtshilfe und Gynäkologie, Frankfurt / Main, Deutschland, Austria

References

• [1] Lurie S., Feinstein M., Mamet Y., Samuel Kristeller: the man and the maneuver., Harefuah, 1999, 136, 653–654
• [2] Kotasek A., Some comments on the so-called Kristeller method., Cesk Gynekol, 1964, 29, 559–561 [PubMed]
• [3] David M., Geburtshilfe. Sinn und Unsinn des Kristellerschen Handgriffs heute-ein Diskussionsbeitrag. Geburtsh Frauenheilk, 2005, 65, 895–898 http://dx.doi.org/10.1055/s-2005-865978[Crossref]
• [4] Cosner K.R., Use of fundal pressure during secondstage labor., A pilot Study. J. Nurse. Midwifery, 1996, 41, 334–347 http://dx.doi.org/10.1016/0091-2182(96)00033-X[Crossref]
• [5] Alran S., Sibony O., Oury J.F., Luton D., Blot P., Differences in management and results in term delivery in nine European referral hospitals: descriptive study., Eur. J. Obstet. Gynecol. Reprod. Biol., 2002, 103, 4–13 http://dx.doi.org/10.1016/S0301-2115(02)00028-3[Crossref]
• [6] Gupta J.K., Nikodem C., Maternal posture in labour., Eur. J. Obstet. Gynecol. Reprod. Biol., 2000, 92, 273–277 http://dx.doi.org/10.1016/S0301-2115(99)00272-9[Crossref]
• [7] Roberts C.L., Algert C.S., Cameron C.A., Torvaldsen S., A meta-analysis of upright positions in the second stage to reduce instrumental deliveries in women with epidural analgesia., Acta Obstet. Gynecol. Scand., 2005, 84, 794–798 http://dx.doi.org/10.1111/j.0001-6349.2005.00786.x[Crossref]
• [8] Neme B., Fraga E., Salomao A.J., Effects of assisted labor on the fetal vascular system. IV. Comparative observations between the use of obstetrical forceps and Kristeller’s maneuver., Matern. Infanc., 1972, 31, 21–24
• [9] Buhimschi C.S., Buhimschi I.A., Malinow A.M., Kopelman J.N., Weiner C.P., The effect of fundal pressure manoeuvre on intrauterine pressure in the second stage of labour., Brit. J. Obstet. Gynecol., 2002, 109, 520–526
• [10] Greenhill J.P., Obstetrics. W.B., Saunders Company, Philadelphia-London, 1960, 974–976
• [11] Habek D., Fetal shoulder dystocia. Acta Med. Croat., 2002, 56, 57–63
• [12] Martius G., External over-rotation of the head in the treatment of high longitudinal shoulder position. Geburtsh Frauenheilk, 1987, 47, 197–201 http://dx.doi.org/10.1055/s-2008-1035807[Crossref]
• [13] Husslein P., Bernaschek G., Huber J.C., Kubista E., Leodolter S. (Eds.). Lehrbuch der Frauenheilkunde. Band 2: Geburtshilfe. Wilhelm Maudrich Verlag, Wien-Munchen-Bern, 2001, 191
• [14] Gallo M., Llamas C., Solano F., Martinez J., Maternal position in labor and delivery: perinatal and maternal effects. U. Kurjak A., ur. Textbook of Perinatal medicine-London-New York: The Parthenon Publishing Group Ltd, 1998, 1761–1769
• [15] Kline-Kaye V., Miller-Slade D., The use of fundal pressure during the second stage of labor.m J. Obstet. Gynecol. Neonatal. Nurs., 1990, 19, 511–517 http://dx.doi.org/10.1111/j.1552-6909.1990.tb01670.x[Crossref]
• [16] Vuković Bobić M., Habek D., Complementary delivery methods. Lijeè Vjesn, 2006, 128, 25–30
• [17] Golay I., Vedam S., Sorger L., The squatting position for the second stage of labor: effects on labor and on maternal and fetal well being. Birth, 1993, 20, 73–78 http://dx.doi.org/10.1111/j.1523-536X.1993.tb00420.x[Crossref]
• [18] Geissbühler V., Geburtshilfe. Alternative Entbindungspositionen: Bett, Stuhl oder Wane., Geburtsh Frauenheilk, 2004, 64, 856–857 http://dx.doi.org/10.1055/s-2004-821265[Crossref]
• [19] David M., Pachaly J., Vetter K., Die Episiotomie: Protektiv oder Risikofaktor beim schweren Dammris? Geburtsh Frauenheilk, 2005, 65, 604–611 http://dx.doi.org/10.1055/s-2005-865700[Crossref]
• [20] Backe J., Wovon Schwangere Träumen-Traumanalysen beu neun Schwangeren Frauen und übersicht über die Literatur. Geburtsh Frauenheilk, 2004, 64, 271–278 http://dx.doi.org/10.1055/s-2004-815812[Crossref]

Identifiers

DOI

10.2478/s11536-008-0008-z