Continuous recording intrarectal pressures during the second phase of labor.
Parameters of intrarectal pressure (surface area under pressure curve and peak pressure) recorded with a microsystem device during the second phase of labor showed no significant correlations with baby's weight or mode of delivery.


OBJECTIVE
Was to assess the biomechanical pressures delivered against pelvic floor structures during the second phase of labor in nulliparae women, and to correlate them with obstetrics parameters, i.e. baby's weight and mode of delivery.


METHODS
Using a microsystem device placed into the rectum at the beginning of the second phase of labor, two parameters were assessed during the bearing efforts in 59 nulliparae women: the surface area under the pressure curve and the peak pressure.


RESULTS
During 11.5±9 bearing efforts of 99.1±16 s duration, the mean value of surface area under the pressure curve was 32677±26058 cm/s and the mean value of the peak pressure was 60.7±24 cmH(2)O, exceeding 100 cmH(2)O in 10% of women. These two parameters were not correlated with baby's weight (R: 0.19, P: 0.15 and R: 0.05, P: 0.71). In the same way, these two parameters were not correlated with the mode of delivery (spontaneous or forceps/vacuum-assisted). Furthermore, the individual values of these two parameters showed great variation from one woman to another.


CONCLUSIONS
This study has showed that parameters of biomechanical pressures recorded into the rectum during second phase of labor had no significant correlations with obstetricals parameters, explaining why these latter have poor predicitive value of further pelvic floor problems.
Urogynecology Unit, Department of Gynecology and Obstetrics, CHUV, 46, rue du Bugnon, 1011 Lausanne, Switzerland. sylvain.meyer@chuv.ch
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Meyer
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Salchli
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Bettaieb
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Hohlfeld
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Achtari
D001724:Birth Weight; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007748:Labor Stage, Second / Q000502:physiology*; D008991:Monitoring, Physiologic; D010298:Parity; D017773:Pelvic Floor / Q000502:physiology; D011247:Pregnancy; D011312:Pressure; D012007:Rectum / Q000502:physiology*