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The Kristeller maneuver is a technique performed with the objective of accelerating labor, in which external pressure is applied to the woman's uterus, with the objective of reducing the expulsive period.
However, and despite this technique being widely used, there is no evidence to prove its benefit, and it may even expose both the woman and the baby to risks.
It is important to emphasize that the birth process should happen, whenever possible, according to the woman's wishes. Thus, the performance of the Kristeller maneuver should only happen if the woman wants to, otherwise the delivery should happen at her natural rhythm.
How the maneuver is performed
The Kristeller maneuver is performed by applying pressure to the bottom of the uterus, that is, the top of the belly, in order to accelerate the expulsion of the baby during delivery.
The indication is that the maneuver is performed using only the hands on the abdominal wall, which allows pressing and directing the baby towards the vaginal opening during contractions.
In which situations it is indicated
The objective of the Kristeller maneuver is to shorten the duration of the expulsive period of labor, accelerating the delivery of the baby. Therefore, in theory, it should only be indicated in situations in which the woman is already exhausted and cannot exert enough force to promote the delivery of the baby.
However, some studies show that this technique is performed as a routine, not being requested by the woman and being performed even if the woman is able to continue to perform the pulls.
Main risks of the maneuver
The risks of the Kristeller maneuver exist due to the lack of consensus on its practice and level of force applied. Although it is recommended that the maneuver be performed using both hands, there are reports of professionals who perform the maneuver using their arms, elbows and knees, which increases the chance of complications.
Some of the risks for women that are associated with the Kristeller maneuver are:
- Possibility of rib fracture;
- Increased risk of bleeding;
- Severe 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 instruments being used during delivery.
In relation to a baby, the Kristeller maneuver can also increase the risk of brain hematomas, clavicle and skull fractures and its effects can be perceived throughout the child's development, which may present seizures, for example, due to birth trauma.
Performing the Kristeller maneuver is also associated with a higher rate of performing episiotomy, which is a procedure that is also performed with the aim of facilitating childbirth, but which should not be performed as an obstetric routine, since that there is no scientific evidence that proves its benefit, in addition to being related to complications for women.