Kristeller's maneuver, also known as fundal pressure, consists of applying force on the upper part of the uterus towards the birth canal to shorten labor.
Generally, this technique is done during the second phase of labor, known as the expulsion phase, and for this, a doctor or nurse stresses the upper part of the pregnant woman's hands or arm during contractions, to help the baby get down.
Although it is a technique used in many births, it is still poorly studied, but some of its known risks include:
- Lacerations in the woman's intimate region; Rupture or inversion of the uterus; Increased need to use forceps or suction cups; Bruises on the baby's head; Fractures of the baby's clavicle or skull; Injuries to the nerves of the baby's arms.
Thus, the Kristeller maneuver should only be used as a last resort when natural labor is being very difficult, in order to reduce the need for a cesarean section.
So, before doing this maneuver, it is recommended to try other techniques such as changing the position of the pregnant woman, encouraging the pregnant woman to exercise or stimulating physical exercise during labor, such as walking around the bedroom, for example.
Meet some of the best exercises that pregnant women can do to facilitate labor.
When the maneuver can be used
The Kristeller maneuver is usually used in situations of:
- Suffering of the baby during delivery; Difficulty in expelling the baby; Excessive tiredness of the pregnant woman; Intense effect of anesthesia that prevents the pregnant woman from pushing the baby.
However, before performing the maneuver, it is important to assess whether the baby is not in shoulder dystocia, which is when one of the shoulders is trapped against the hip bones of the pregnant woman, because if applied in these cases, the maneuver does not resolve the dystocia and it can also cause serious nerve damage to the baby's arm.
