Expression of the fetus by holding the uterine fundus
This method is widely used in Czech obstetrics. It is quite incorrectly called the Kristeller expression , even though it has nothing to do with Kristeller's original description.
In modern obstetrics, however, even this method is replaced in indicated cases either by pharmacological strengthening of the uterine activity of uterotonics, or by extraction of the fetus with forceps or a vacuum extractor .
Performance indication
The indication is the acute need to shorten the second period of labor
Performance technique
It is performed only during uterine contraction by pressing on the uterine fundus with the forearm (not with both palms). It is not possible to apply point pressure with an elbow or fist. The intensity of the expression copies the contraction wave, and the mother uses an abdominal press.
Terms of performance
- The wicket sends them away;
- amniotic fluid flows ;
- there are no signs of disproportion between the head of the fetus and the pelvis of the mother;
- the head enters at least a large section into the pelvis and cannot be pushed out;
- uterine contractions are present;
- there is no contraindication to the use of the abdominal press.
Contraindications to performance
Absolute
- Suspected cephalopelvic disproportion;
- imminent rupture of the uterus;
- uterine hypertension or hypotonia;
- absence of uterine contractions;
- conditions after uterine surgery;
- inability to use the abdominal press.
Relative
- Fetal emergency (the expression can be used only if it can be expected to end labor faster than during the preparation for the extraction operation, or the expression can be used during the preparation for the extraction operation);
- position of the fetus at the pelvic end.
References
References
- UNZEITIG, Vít and Petr JANKŮ. Kristeller's expression in modern obstetrics. Modern gynecology and obstetrics. 2000, vol. 9, no. 1, pp. 308-312, ISSN 1211-1058.
