title: The modified Mueller-Hillis maneuver in predicting abnormalities in second stage labor.
abstract: OBJECTIVE
  To assess prospectively the utility of a modification of the Mueller-Hillis maneuver in predicting abnormalities of the second stage of labor.
  
  
  METHODS
  The Mueller-Hillis maneuver was modified by limiting its use to the second stage of labor during a contraction. The maneuver was performed by one examiner; descent of 1 cm or more was deemed a positive maneuver. Descent less than 1 cm was deemed a negative maneuver. Labor outcomes were analyzed according to the results of this maneuver.
  
  
  RESULTS
  Seventy patients were enrolled in this study. Fifty-one (72.9%) had > or = 1 cm descent maneuver and 19 (27.1%) had < or = 1 cm descent. A descent > or = 1 cm was significantly predictive of vaginal delivery (100%) and a descent < or = 1 cm was significantly associated with an increased cesarean section rate (P = 0.001), prolonged second stage of labor (P = 0.001), abnormal position (P = 0.01) and higher station (P = 0.001).
  
  
  CONCLUSIONS
  A positive modified Mueller-Hillis maneuver in second stage labor had a high predictive value for vaginal delivery, whereas a negative maneuver was significantly associated with high operative delivery rate, prolonged second stage labor and abnormal position. These results indicate that this modification of the Mueller-Hillis maneuver needs to be considered for its utility in second stage labor.
authors.affiliation: Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: March
authors.forename: C D
authors.initials: CD
authors.lastname: Adair
authors.forename: J C
authors.initials: JC
authors.lastname: Veille
authors.forename: D R
authors.initials: DR
authors.lastname: Burrus
mesh_terms: D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D009774:Obstetrics / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D014590:Uterine Contraction