A manobra de Kristeller é uma técnica realizada com o objetivo de acelerar o trabalho de parto em que é realizada pressão sobre o útero da mulher, diminuindo o período expulsivo. No entanto, apesar dessa técnica ser bastante utilizada, não existem evidências que comprovem o seu benefício, além de que expõe tanto a mulher quanto o bebê a riscos.
It is important to note that childbirth should be at the woman’s choice, provided there are no contraindications, so Kristeller’s manoeuvre should be performed only if the woman wishes, otherwise the delivery should be carried out according to her desire.
- Kristeller’s maneuver should not be performed due to the risks to the woman and baby that are related to her practice.
- And there is no evidence of its benefits.
The purpose of Kristeller’s manoeuvre is to reduce the duration of the expulsion period of delivery by accelerating the baby’s exit and, to do so, pressure is applied to the lower part of the uterus to promote the baby’s exit, so in theory it would be indicated in situations where the woman is already exhausted and cannot exert enough strength to promote the baby’s exit.
However, some studies show that this technique is routinely performed, is not requested by the woman and is performed even if the woman is able to continue performing the dominated ones, in addition to evidence that the maneuver does not reduce expulsion and exposes the woman and baby to unnecessary risks.
The risks of Kristeller’s manoeuvre exist due to a lack of consensus on its practice and the level of force applied, although it is indicated that the maneuver is performed with both hands on the lower part of the uterus in the abdominal wall, there are reports of professionals performing the maneuver with the arms, elbows and knees, which increases the risk of complications.
Risks to women associated with Kristeller’s maneuver include
In addition, doing this can also increase a woman’s discomfort and pain during labor, increasing the likelihood of using instruments during childbirth.
For the baby, the Kristeller maneuver can also increase the risk of brain bruising, clavicle and skull fracture and its effects can be seen throughout the development of the child, who may have seizures, for example, after trauma during childbirth .
Kristeller’s maneuver is also associated with a higher rate of episiotomy, which is a procedure that is also performed with the aim of facilitating childbirth, but should not be performed as an obstetric routine, as there is no scientific evidence to demonstrate its benefits., in addition to being linked to complications for women.