The Association Between Kristeller Maneuver and Pelvic Floor Trauma After Vaginal Delivery

Bezmialem Vakif University86 enrolled

Overview

We want to investigate the association between fundal pressure in the second stage and the risk of levator ani muscle (LAM) injury.

We will recruit women immediately following their first vaginal delivery. Women who underwent Kristeller maneuver will be recruit as cases. For each case, a control (no fundal pressure) will be recruit matched by BMI, second stage duration and birthweight. All women will be invited to undergo a postpartum 3D transperineal ultrasound (TPUS). The main outcome measure will be the presence of LAM avulsion at 3D TPUS. TPUS results will be compared between cases and controls.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Labor Complication Avulsion

Interventions

Fundal PressurePROCEDURE

Fundal Pressure to assist the vaginal delivery to shorten the second stage of labor

Eligibility

Sex: FEMALEMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * First delivery * Term pregnancy (37-41w) Exclusion Criteria: * Instrumental vaginal delivery * Multifetal pregnancy * Previous vaginal or cesarean delivery * Refused consent and uncooperative patient for effective Valsalva maneuver * Handicap in lithotomy position * Women without regular and active contractions * Epidural analgesia

Locations (1)

Bezmialem Vakıf University Hospital

Istanbul, Turkey (Türkiye)

Outcomes

Primary Outcomes

levator ani muscle (LAM) injury

The aim of the study is to investigate levator ani muscle (LAM) injury, loss of tenting, biometric measurements of LAM and genital hiatus after vaginal delivery and investigate the association between fundal pressure in the second stage of labor (Kristeller maneuver). All recruited women will be invited to undergo a transperineal 3D ultrasound (TPUS) scan at 24 hours after delivery. we will acquire two 3D volumes for each patient: one under maximum pelvic floor muscle contraction (PFMC) and the other under maximum Valsalva's maneuver. Ballooning" will diagnosed with a pelvic hiatal area of more than 25 cm2 during maximum Valsalva. A complete avulsion of the puborectalis muscle will diagnose if an abnormal insertion of the muscle will be detected on all three central slices. We will use a levator-urethral gap more than 2.5 cm to define an abnormal insertion.

Time frame: 24 hour

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.