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

Abstract

<jats:title>Abstract</jats:title><jats:p>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.</jats:p>

Intrapartal uterine avulsion with posterior cervical rupture

“…The potential risk factors certainly include traumatic events, as well as aggressively applied fundal pressure and hyperpolysystolie. (6,7) A case is described of complete left-sided intrapartum uterine avulsion with posterior cervical rupture in a secundipara following vacuum extraction. To the best of our knowledge, a similar report has not been previously reported.…”

Global Perspectives: Maternity Care and Practices in Ethiopia

“…And regardless of the intention, the fact remains that research has widely found the practice to have the potential for harm, with WHO expressively not recommending it 4 and most national midwifery councils and colleges acknowledging the possible damaging consequences. 2 Moving beyond the physical aftereffects, the traumatising nature of being forced into having fundal pressure is deeply felt. Many women responding to the images with their own stories report their feelings of failure, of not having given birth, of their objections being dismissed.…”

“…Of course, the midwives knew the potential complications of using fundal pressure, from complicated lacerations to uterine rupture and shoulder dystocia. 2 They were also aware of my feelings towards the practice. Never once, in a year and a half of working alongside them, had I wavered from my fierce stance against the practice.…”

Elderly and Foreign: Vulnerability and Intersectionality in Healthcare

“…Cecilin popis odpovídá postupu kontroverzní intervence známé jako Kristellerova exprese, na jejíž škodlivost upozornila řada vědců (např. Habek et al 2008;Mehri, Awonuga 2005). Prudká bolest, kterou Cecily při takovém zákroku pocítila, však nebyla tím nejhorším.…”