title: The effects of uterine fundal pressure (Kristeller maneuver) on pelvic floor function after vaginal delivery.
abstract: OBJECTIVE
  To evaluate the role of uterine fundal pressure during the second stage of labor (Kristeller maneuver) on pelvic floor dysfunction (urinary and anal incontinence, genital prolapse, pelvic floor strength).
  
  
  METHODS
  522 primiparous women, enrolled 3 months after vaginal delivery, were divided in two groups: group A (297 women) identifies the women who received Kristeller maneuvers with different indications (e.g. fetal distress, failure to progress, mother exhaustion), group B (225 women) the women without maneuver. Participants were questioned about urogynecological symptoms and examined by Q-tip test, digital test, vaginal perineometry and uroflowmetric stop test score.
  
  
  RESULTS
  Mediolateral episiotomies, dyspareunia and perineal pain were significantly higher in Kristeller group, whereas urinary and anal incontinence, genital prolapse and pelvic floor strength were not significantly different between the groups.
  
  
  CONCLUSIONS
  Kristeller maneuver does not modify puerperal pelvic floor function but increases the rate of episiotomies.
authors: Department of Obstetrics and Gynecology, IRCCS Burlo Garofolo, University of Trieste, Trieste, Italy. sartore@burlo.trieste.it
authors: Andrea
authors: A
authors: Sartore
authors: Francesco
authors: F
authors: De Seta
authors: Gianpaolo
authors: G
authors: Maso
authors: Giuseppe
authors: G
authors: Ricci
authors: Salvatore
authors: S
authors: Alberico
authors: Massimo
authors: M
authors: Borelli
authors: Secondo
authors: S
authors: Guaschino
mesh_terms: D036861:Delivery, Obstetric / Q000009:adverse effects*; D004414:Dyspareunia / Q000209:etiology; D004420:Dystocia / Q000628:therapy; D004841:Episiotomy; D005221:Fatigue / Q000628:therapy; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005316:Fetal Distress / Q000628:therapy; D006801:Humans; D007748:Labor Stage, Second / Q000502:physiology*; D010149:Postoperative Pain / Q000209:etiology; D017773:Pelvic Floor / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000209:etiology; D010502:Perineum; D011247:Pregnancy; D011312:Pressure / Q000009:adverse effects*; D011644:Puerperal Disorders / Q000209:etiology*; D014549:Urinary Incontinence / Q000209:etiology; D014599:Uterus / Q000502:physiology*