Kristeller maneuvers or fundal pressure and maternal/neonatal morbidity: obstetric and judicial literature review

Abstract Aim: A significant amount of data concerning maternal-fetal damage arising from the exertion of Kristeller maneuvers (KMs) or fundal pressure (FP) go unreleased due to medicolegal implications. Materials and methods: For this reason, the paper gathers information as to the real magnitude of litigation related to FP-induced damages and injuries. The authors have undertaken a research in order to include general search engines (PubMed-Medline, Cochrane, Embase, Google, GyneWeb) and legal databases (De Jure, Italian database of jurisprudence daily update; Westlaw, Thomson Reuters, American ruling database and Bailii, UK Court Ruling Database). Results: Results confirm said phenomenon to be more wide ranging than it appears through official channels. Several courts of law, both in the United States of America (USA) and in European Union (EU) Member States as well, have ruled against the use of the maneuver itself, assuming a stance conducive to a presumption of guilt against those doctors and healthcare providers who resorted to KMs or FP during deliveries. Given how rife FP is in mainstream obstetric practice, it is as if there were a wide gap between obstetric real-life and what official jurisprudence and healthcare institutions-sanctioned official practices are. Conclusion: The authors think that it would be desirable to draft specifically targeted guidelines or recommendations on maneuvers during vaginal delivery, in which to point out exactly what kinds of maneuvering techniques are to be absolutely banned and what maneuvers are to be allowed, and under what conditions their application can be considered appropriate.

[1]  W. H. Pearse,et al.  American College of Obstetricians and Gynecologists , 2018, Definitions.

[2]  A. Tinelli,et al.  “Can the intrapartum ultrasonography reduce the legal liability in distocic labor and delivery?” , 2018, 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.

[3]  F. Signore,et al.  The issue of delivery room infections in the Italian law. A brief comparative study with English and French jurisprudence , 2018, 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.

[4]  E. Marinelli,et al.  Assessing malpractice lawsuits for death or injuries due to amniotic fluid embolism. , 2017, La Clinica terapeutica.

[5]  M. Senat,et al.  Shoulder dystocia: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF). , 2016, European journal of obstetrics, gynecology, and reproductive biology.

[6]  T. Ikeda,et al.  Uterine rupture after the uterine fundal pressure maneuver , 2015, Journal of perinatal medicine.

[7]  T. Thubert,et al.  [Management of third and fourth degree perineal tears: A systematic review]. , 2015, Journal de gynecologie, obstetrique et biologie de la reproduction.

[8]  M. Sehat,et al.  Measurement of Disability and Its Predictors Among Trauma Patients: A Follow-up Study , 2015, Archives of trauma research.

[9]  J. Bartha,et al.  Intrapartum ultrasound prior to Kristeller maneuver: an observational study , 2015, Journal of perinatal medicine.

[10]  A. Talebian,et al.  Incidence of Neonatal Birth Injuries and Related Factors in Kashan, Iran , 2014, Archives of trauma research.

[11]  S. Matsubara Uterine fundal pressure: Is it really a culprit of poor maternal and neonatal outcome? , 2014, The journal of obstetrics and gynaecology research.

[12]  F. Moiety,et al.  Fundal pressure during the second stage of labor in a tertiary obstetric center: A prospective analysis , 2014, The journal of obstetrics and gynaecology research.

[13]  O. Bortolami,et al.  Fundal pressure (Kristeller maneuver) during labor in current obstetric practice: assessment of prevalence and feto-maternal effects. , 2014, Minerva ginecologica.

[14]  P. Frati,et al.  Not only a clinical nightmare: amniotic fluid embolism in court. , 2014, Current pharmaceutical biotechnology.

[15]  Z. Foldes-Papp,et al.  Amniotic fluid embolism: what level of scientific evidence can be drawn? A systematic review. , 2014, Current pharmaceutical biotechnology.

[16]  Shunji Suzuki,et al.  Clinical Significance of Deliveries With Uterine Fundal Pressure Maneuver at a Single Perinatal Center in Japan , 2013 .

[17]  E. Cosmi,et al.  An inflatable ergonomic 3‐chamber fundal pressure belt to assist vaginal delivery , 2013, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[18]  Susan Tongate,et al.  Nurses, physicians and disagreements about fundal pressure: how we used evidence to change practice. , 2010, Nursing for women's health.

[19]  J. Raven,et al.  Fundal pressure during the second stage of labour. , 2018, The Cochrane database of systematic reviews.

[20]  S. Bergström,et al.  Obstetric care in low‐resource settings: What, who, and how to overcome challenges to scale up? , 2009, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[21]  M. Kurdoğlu,et al.  Delayed diagnosis of an atypical rupture of an unscarred uterus due to assisted fundal pressure: a case report , 2009, Cases journal.

[22]  Y. Shiki,et al.  Use of uterine fundal pressure maneuver at vaginal delivery and risk of severe perineal laceration , 2009, Archives of Gynecology and Obstetrics.

[23]  O. Api,et al.  The effect of uterine fundal pressure on the duration of the second stage of labor: A randomized controlled trial , 2009, Acta obstetricia et gynecologica Scandinavica.

[24]  D. Kostadinova,et al.  [Abdominal expression of the fetus in the 21st century]. , 2009, Akusherstvo i ginekologiia.

[25]  I. Baloyiannis,et al.  Rib fractures with heamothorax after labor: a case report. , 2009, Cases journal.

[26]  S. Chauhan,et al.  Evidence-based labor and delivery management. , 2019, American journal of obstetrics and gynecology.

[27]  E. Waszyński [Kristeller's procedure--Expressio fetus, its genesis and contemporary application]. , 2008, Ginekologia polska.

[28]  E. Ryding,et al.  Sexuality after Delivery with Episiotomy: A Long-Term Follow-Up , 2008, Gynecologic and Obstetric Investigation.

[29]  D. Habek,et al.  Uteroplacental apoplexy (Couvelaire syndrome) , 2008, Wiener klinische Wochenschrift.

[30]  J. Tukur,et al.  Uterine prolapse following fundal pressure in the first stage of labour: a case report. , 2007, Annals of African medicine.

[31]  Chih-ping Chen,et al.  Uterine rupture due to traumatic assisted fundal pressure. , 2006, Taiwanese journal of obstetrics & gynecology.

[32]  T. Y. Kim,et al.  The effect of fundal pressure at Caesarean section on maternal haemodynamics , 2006, Anaesthesia.

[33]  H. Hagberg,et al.  Risk Factors for Obstetric Brachial Plexus Palsy Among Neonates Delivered by Vacuum Extraction , 2005, Obstetrics and gynecology.

[34]  Z. Merhi,et al.  The Role of Uterine Fundal Pressure in the Management of the Second Stage of Labor: A Reappraisal , 2005, Obstetrical & gynecological survey.

[35]  Hun-Shan Pan,et al.  Uterine rupture in an unscarred uterus after application of fundal pressure. A case report. , 2002, The Journal of reproductive medicine.

[36]  K. Simpson,et al.  Fundal pressure during the second stage of labor. , 2001, MCN. The American journal of maternal child nursing.

[37]  S. Paterson–Brown,et al.  Does an inflatable obstetric belt facilitate spontaneous vaginal delivery in nulliparae with epidural analgesia? , 1999, British journal of obstetrics and gynaecology.

[38]  G. Roberts Shoulder dystocia , 1999, British journal of obstetrics and gynaecology.

[39]  D. Rouse,et al.  Active-phase labor arrest: oxytocin augmentation for at least 4 hours. , 1999, Obstetrics and gynecology.

[40]  C. Amiel‐Tison Clinical neurology in neonatal units. , 1998, Croatian medical journal.

[41]  K. Cosner,et al.  Use of fundal pressure during second-stage labor. A pilot Study. , 1996, Journal of nurse-midwifery.

[42]  D. Miller-Slade,et al.  The use of fundal pressure during the second stage of labor. , 1990, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[43]  A. B. Steele Mechanical Pressure in Inertia of the Uterus , 1872, British medical journal.