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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

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Volume 43, Issue 2


Intrapartum ultrasound prior to Kristeller maneuver: an observational study

Marcos Javier Cuerva / Pablo Tobias / Jose Angel Espinosa / Jose Luis Bartha
Published Online: 2014-07-17 | DOI: https://doi.org/10.1515/jpm-2014-0079


Objectives: To evaluate the accuracy of criteria followed by obstetricians when performing a Kristeller maneuver in cases of prolonged second stage of labor.

Methods: In this prospective observational study, the station of the fetal head was measured using the angle of progression (intrapartum ultrasound) just prior to the intervention of the managing obstetrician in 52 women with prolonged second stage of labor. The managing obstetricians were blinded to the sonographic results. The decision of performing a Kristeller maneuver was taken by the obstetricians based on digital palpation and their experience. Delivery mode, Apgar score, umbilical artery pH value, episiotomy, perineal tears, bleeding, and time to delivery were recorded.

Results: Kristeller maneuver was performed in 36/52 (69.2%) cases. There were no significant differences between the Kristeller and the non-Kristeller group regarding the angle of progression. There were no significant differences between both groups with respect to delivery mode, perineal tears, episiotomy, bleeding, Apgar score, and umbilical artery pH value.

Conclusions: Our study failed to define any criteria followed by obstetricians when performing a Kristeller maneuver in cases of prolonged second stage of labor. There was no relation between the angle of progression and the decision to perform a Kristeller maneuver.

Keywords: Angle of progression; intrapartum ultrasound; Kristeller maneuver


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About the article

Corresponding author: Marcos Javier Cuerva, MD, Department of Obstetrics, Quiron San Jose Hospital, Cartagena, 111, 28002 Madrid, Spain, Tel.: +34 677026551, E-mail:

Received: 2014-03-04

Accepted: 2014-06-30

Published Online: 2014-07-17

Published in Print: 2015-03-01

Citation Information: Journal of Perinatal Medicine, Volume 43, Issue 2, Pages 171–175, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2014-0079.

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