OP28.10: The effect of Kristeller manoeuvre on postpartum pelvic organ prolapse: prospective case‐control study

Abstract

Objectives:To evaluate the effect of the Kristeller manoeuvre on female pelvic organ prolapse and pelvic dysfunction symptoms in primiparous women 3-6 months after delivery. Methods: Prospective case-control trial. Patients who underwent fundal pressure in the second stage of labour were recruited as ''cases''. For every case a matched ''control'' patient with spontaneous vaginal delivery was enrolled. All patients were evaluated 3-6 months after vaginal delivery through a 3D/4D transperineal ultrasound clinical assessment, to evaluate the presence and the degree of pelvic organ prolapse using the Pelvic Organ Prolapse quantification system (POP-q) both performed by an operator blinded to the patient's history. Results: Overall, 134 cases and 128 controls underwent the postpartum assessment. No significant difference was demonstrated between the 2 groups as regards maternal age, BMI, gestational age at delivery, birthweight, epidural analgesia, second stage length, and labour length, while maternal weight was significantly higher in the Kristeller group. Women who underwent Kristeller manoeuvre had a higher incidence of operative delivery, mediolateral episiotomy and the presence of III IV degree perineal lacerations.There were no statistically significant differences in terms of development of clinical nor ultrasonographic pelvic organs prolapse between the two groups. Furthermore, no statistically significant difference was found between the 2 groups regarding pelvic floor dysfunction symptoms. Conclusions: In this short follow-up study, the use of Kristeller manoeuvre does not seem to be associated with a higher risk of prolapse or pelvic floor dysfunction symptoms. were generated for both groups of examiners. General and specific to each anomaly eye tracking parameters were recorded for all cases (time to first fixation, first fixation duration, fixation duration, and fixation count) together with voice conclusions. Results: Heat maps demonstrated evident differences in perception of fetal echocardiograms between BE and EE in terms of abnormal cases. No differences were observed in general eye tracking parameters for normal cases (mean total fixation duration for BE was 5.39s vs 5.36s for EE) and for anomalies (mean total fixation duration for BE was 7.51s vs 7.32s for EE). Clear differences were noted in specific areas for each anomaly by eye tracking parameters and in voice recordings. Conclusions: This is the first study aimed at perception understanding between basic and experienced examiner in fetal echocardiography. Eye tracking modalities may be helpful in teaching, because they allow for demonstrating examiner's pattern recognition process. Objectives: The Thermal Index (TI) and Mechanical Index (MI) were introduced to provide the operator with an indication of the potential for ultrasound induced bio-effects. Most of the safety regulations stipulate limits for these two parameters that should be fulfilled during the examination. We analysed historical information from an archive of recorded examinat...