Shortening the second stage of labor?

Mahendru, Rajiv

doi:10.5152/jtgga.2010.07

Cited by 9 publications

(10 citation statements)

References 16 publications

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“…Em um dos relatos a parturiente descreve que em sua primeira gestação, durante o trabalho de parto, dois médicos teriam subido sobre seu abdômen, usando de força com o intuito de acelerar a expulsão do concepto. Contudo, um estudo evidencia que a pressão exercida no Research, Society and Development, v. 9, n. 7, e934975086, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i7.5086 8 fundo do útero não se mostra eficaz com o objetivo de reduzir o tempo do segundo momento do parto, além disso, eleva a taxa de episiotomia, retenção de placenta, fraturas e danos ao recém-nascido (Mahendru, 2010).…”

Section: Resultsunclassified

A percepção das gestantes sobre o parto humanizado e violência obstétrica: relato de experiência

Brito

Fonteles

Gimenes

et al. 2020

RSD

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This work aims to report the perception of pregnant women regarding humanized childbirth and obstetric violence and identify which practices pregnant women associate with humanized childbirth and obstetric violence. This is an experience report based on the problematization methodology approached together in the Charlez Maguerez arc. The arc is composed of five stages: observation of reality, survey of key points, theorization, hypotheses of solution and return to reality. Before that, it was found a significant number of pregnant women who suffered from practices that constitute obstetric violence, but not associated with them, said as a negligence in care during the delivery process, pointing to the quality of care provided, highlighting the lack of knowledge of pregnant women about their rights and the theme of humanized childbirth. It is concluded that much progress has been made in the search for humanization, however, there are still distortions about the humanization process, emphasizing that women need to be instructed in prenatal care, giving them incentives to be protagonists of their lives, including not only reproductive life, but also their empowerment, to defend themselves any form of violence.

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Section: Resultsunclassified

A percepção das gestantes sobre o parto humanizado e violência obstétrica: relato de experiência

Brito

Fonteles

Gimenes

et al. 2020

RSD

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“…Applying fundal pressure has been both recommended and condemned as a strategy for assisting birth in the management of shoulder dystocia [14, 15]. To our knowledge, the only published randomized controlled trials (RCTs) of manual fundal pressure during vaginal birth have found no benefits associated with its use, but the numbers studied were small [16, 30]. A pilot RCT of manual fundal pressure compared with standard care in 209 nulliparous women with uncomplicated pregnancies in a hospital in India found no significant reduction in the duration of the second stage of labour, but an increase in perineal injuries [16].…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, the only published randomized controlled trials (RCTs) of manual fundal pressure during vaginal birth have found no benefits associated with its use, but the numbers studied were small [16, 30]. A pilot RCT of manual fundal pressure compared with standard care in 209 nulliparous women with uncomplicated pregnancies in a hospital in India found no significant reduction in the duration of the second stage of labour, but an increase in perineal injuries [16]. A 2005 review of the manoeuvre concluded that the role of fundal pressure is understudied and caution should be exercised until it is proven to be safe and effective [11].…”

Section: Introductionmentioning

confidence: 99%

A multicentre randomized controlled trial of gentle assisted pushing in the upright posture (GAP) or upright posture alone compared with routine practice to reduce prolonged second stage of labour (the Gentle Assisted Pushing study): study protocol

et al. 2015

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BackgroundFundal pressure (pushing on the upper part of the uterus in the direction of the birth canal) is often performed in routine practice, however the benefit and indications for its use are unclear and vigorous pressure is potentially harmful. There is some evidence that it may be applied routinely or to expedite delivery in some situations (e.g. fetal distress or maternal exhaustion), particularly in settings where other methods of achieving delivery (forceps, vacuum) are not available. Gentle assisted pushing (GAP) is an innovative method of applying gentle but steady pressure to the uterine fundus with the woman in an upright posture. This trial aims to evaluate the use of GAP in an upright posture, or upright posture alone, on reducing the mean time of delivery and the associated maternal and neonatal complications in women not having delivered following 15-30 min in the second stage of labour.Methods/DesignWe will conduct a multicentre, randomized, unblinded, controlled trial with three parallel arms (1:1:1). 1,145 women will be randomized at three hospitals in South Africa. Women will be eligible for inclusion if they are ≥18 years old, nulliparous, gestational age ≥ 35 weeks, have a singleton pregnancy in cephalic presentation and vaginal delivery anticipated. Women with chronic medical conditions or obstetric complications are not eligible. If eligible women are undelivered following 15-30 min in the second stage of labour, they will be randomly assigned to: 1) GAP in the upright posture, 2) upright posture only and 3) routine practice (recumbent/supine posture). The primary outcome is the mean time from randomization to complete delivery. Secondary outcomes include operative delivery, adverse neonatal outcomes, maternal adverse events and discomfort.DiscussionThis trial will establish whether upright posture and/or a controlled method of applying fundal pressure (GAP) can improve labour outcomes for women and their babies. If fundal pressure is found to have a measurable beneficial effect, this gentle approach can be promoted as a replacement for the uncontrolled methods currently in use. If it is not found to be useful, fundal pressure can be discouraged.

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“…Apesar de pesquisas recentes não demonstrarem benefícios na realização da pressão no fundo uterino no momento do período expulsivo (manobra de Kristeller), esta intervenção é comumente utilizada durante o cuidado prestado ao parto, principalmente com o intuito de encurtar o segundo período do parto (MATSUO et al, 2009;API et al, 2009;MAHENDRU, 2010;SARTORE et al, 2012). O Kristeller não possui respaldo científico suficiente para sua realização rotineira nos serviços.…”

Section: Objetivos Específicosunclassified

“…Esta prática possui grandes riscos a desfechos desfavoráveis e demonstra ser ineficaz, devendo não ser realizada nas mulheres (MATSUO et al, 2009;MAHENDRU, 2010;SARTORE et al, 2012). Revisão sistemática realizada com um único estudo envolvendo 500 mulheres teve como objetivo comparar o uso da pressão do fundo uterino, por meio de um cinto inflável, com a não realização desta intervenção.…”

Section: Objetivos Específicosunclassified

Assistência ao parto e presença do acompanhante: um estudo sobre as jovens do Inquérito Nacional sobre Parto e Nascimento - \"Nascer no Brasil

Siqueira¹

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Shortening the second stage of labor?

Abstract: Application of uterine fundal pressure in a delivering woman was not only ineffective in shortening the second stage of labor but added to the risks during parturition.

Cited by 9 publications

References 16 publications

A percepção das gestantes sobre o parto humanizado e violência obstétrica: relato de experiência

A percepção das gestantes sobre o parto humanizado e violência obstétrica: relato de experiência

A multicentre randomized controlled trial of gentle assisted pushing in the upright posture (GAP) or upright posture alone compared with routine practice to reduce prolonged second stage of labour (the Gentle Assisted Pushing study): study protocol

Assistência ao parto e presença do acompanhante: um estudo sobre as jovens do Inquérito Nacional sobre Parto e Nascimento - \"Nascer no Brasil

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