The Kristeller maneuver is a technique performed with the objective of accelerating labor, in which external pressure is carried out on the woman’s uterus, in order to reduce the expulsive period.
However, and although this technique is widely used, there is no evidence to prove its benefit, and may even expose both women and babies to risks.
It is important to note that the birth process should happen, whenever possible, according to those of the woman. Thus, the realization of the Kristeller maneuver should only happen if the woman wishes, otherwise the delivery must happen at her natural rhythm.
How the maneuver is done
The Kristeller maneuver is done by applying pressure to the bottom of the uterus, that is, at the top of the belly, in order to accelerate the expulsion of the baby during childbirth.
The indication is that the maneuver is done using only the hands on the abdominal wall, which allows to press and direct the baby to the vaginal opening during contractions.
In which situations is indicated
The goal of Kristeller’s maneuver is to shorten the duration of the expulsive period of childbirth, accelerating the baby’s exit. Therefore, in theory, it should be indicated only in situations in which the woman is already exhausted and cannot perform enough force to promote the baby’s exit.
However, some studies show that this technique is performed as routine, not being requested by the woman and being performed even if the woman is in a position to continue to perform the pulls.
Main risks of manoeuvre
The risks of Kristeller’s manoeuvre exist due to a lack of consensus about his practice and level of force applied. Although it is indicated that the maneuver is performed using both hands, there are reports of professionals who perform the maneuver using the arms, elbows and knees, which increases the chance of complications.
Some of the risks to the woman who are associated with Kristeller’s maneuver are:
- Possibility of fracture of the ribs;
- Increased risk of bleeding;
- Serious lacerations in the perineum, which is the region that supports the pelvic organs;
- Displacement of the placenta;
- abdominal pain after childbirth;
- Possibility of rupture of some organs, such as spleen, liver and uterus.
In addition, performing this maneuver can also increase discomfort and pain during labor, increasing the likelihood of using instruments during delivery.
In relation to the baby, the Kristeller maneuver can also increase the risk of brain hematomas, fractures in the collarbone and skull and its effects can be perceived throughout the development of the child, which may present seizures, for example, due to labor trauma.
The performance of the Kristeller maneuver is also associated with the higher rate of episiotomy, which is a procedure that is also performed with the objective of facilitating childbirth, but should not be performed as an obstetric routine, since there is no scientific evidence to prove its benefit, besides also being related to complications for women.
