The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition

Detalhes bibliográficos
Autor(a) principal: Lemos,Andrea
Data de Publicação: 2011
Outros Autores: Dean,Elizabeth, Andrade,Armèle Dornelas de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Physical Therapy
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552011000100012
Resumo: OBJECTIVES: This cross-sectional study was designed to examine the effects of the Valsalva Maneuver (VM) and its duration on the acid- base equilibrium of the neonate and its maternal repercussions during the expulsive stage of labor, after standard breathing and pushing instructions were given. METHODS: A convenience sample of women with low risk pregnancy (n=33; mean age 22.5±3.7y and gestational age 38.1±1.12wks) and their newborns were studied during the expulsive stage of vaginal labor. Coaching consisted of standard recommendations for breathing including prolonged VMs coordinated with pushing. Maternal outcomes included the need for uterus fundal pressure maneuver and episiotomy, perineal trauma and posture. Neonatal outcomes included blood gases sampled from the umbilical cord, and Apgar scores. Data were analyzed with the Fisher's exact test, chi-square test, and Pearson correlation coefficient. RESULTS: None of the maternal outcomes were associated with VM duration. With respect to neonatal outcomes, increased VM duration was associated with reduced venous umbilical pH (r=-0.40; p=0.020), venous base excess (r=-0.42; p=0.014) and with arterial base excess (r=-0.36; p=0.043). Expulsive stage time was negatively associated with umbilical venous and arterial pH. CONCLUSIONS: VM duration during fetal expulsion in labor negatively affects fetal acid-base equilibrium and potentially the wellbeing of the neonate. Our results support the need to consider respiratory strategies during labor, to minimize potential risk to the mother and neonate.
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spelling The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth conditionValsalva maneuverpushing"labour, obstetric"umbilical cordOBJECTIVES: This cross-sectional study was designed to examine the effects of the Valsalva Maneuver (VM) and its duration on the acid- base equilibrium of the neonate and its maternal repercussions during the expulsive stage of labor, after standard breathing and pushing instructions were given. METHODS: A convenience sample of women with low risk pregnancy (n=33; mean age 22.5±3.7y and gestational age 38.1±1.12wks) and their newborns were studied during the expulsive stage of vaginal labor. Coaching consisted of standard recommendations for breathing including prolonged VMs coordinated with pushing. Maternal outcomes included the need for uterus fundal pressure maneuver and episiotomy, perineal trauma and posture. Neonatal outcomes included blood gases sampled from the umbilical cord, and Apgar scores. Data were analyzed with the Fisher's exact test, chi-square test, and Pearson correlation coefficient. RESULTS: None of the maternal outcomes were associated with VM duration. With respect to neonatal outcomes, increased VM duration was associated with reduced venous umbilical pH (r=-0.40; p=0.020), venous base excess (r=-0.42; p=0.014) and with arterial base excess (r=-0.36; p=0.043). Expulsive stage time was negatively associated with umbilical venous and arterial pH. CONCLUSIONS: VM duration during fetal expulsion in labor negatively affects fetal acid-base equilibrium and potentially the wellbeing of the neonate. Our results support the need to consider respiratory strategies during labor, to minimize potential risk to the mother and neonate.Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia 2011-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552011000100012Brazilian Journal of Physical Therapy v.15 n.1 2011reponame:Brazilian Journal of Physical Therapyinstname:Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia (ABRAPG-FT)instacron:ABRAPG-FT10.1590/S1413-35552011000100012info:eu-repo/semantics/openAccessLemos,AndreaDean,ElizabethAndrade,Armèle Dornelas deeng2011-05-03T00:00:00Zoai:scielo:S1413-35552011000100012Revistahttps://www.scielo.br/j/rbfis/https://old.scielo.br/oai/scielo-oai.phpcontato@rbf-bjpt.org.br||contato@rbf-bjpt.org.br1809-92461413-3555opendoar:2011-05-03T00:00Brazilian Journal of Physical Therapy - Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia (ABRAPG-FT)false
dc.title.none.fl_str_mv The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition
title The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition
spellingShingle The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition
Lemos,Andrea
Valsalva maneuver
pushing
"labour, obstetric"
umbilical cord
title_short The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition
title_full The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition
title_fullStr The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition
title_full_unstemmed The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition
title_sort The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition
author Lemos,Andrea
author_facet Lemos,Andrea
Dean,Elizabeth
Andrade,Armèle Dornelas de
author_role author
author2 Dean,Elizabeth
Andrade,Armèle Dornelas de
author2_role author
author
dc.contributor.author.fl_str_mv Lemos,Andrea
Dean,Elizabeth
Andrade,Armèle Dornelas de
dc.subject.por.fl_str_mv Valsalva maneuver
pushing
"labour, obstetric"
umbilical cord
topic Valsalva maneuver
pushing
"labour, obstetric"
umbilical cord
description OBJECTIVES: This cross-sectional study was designed to examine the effects of the Valsalva Maneuver (VM) and its duration on the acid- base equilibrium of the neonate and its maternal repercussions during the expulsive stage of labor, after standard breathing and pushing instructions were given. METHODS: A convenience sample of women with low risk pregnancy (n=33; mean age 22.5±3.7y and gestational age 38.1±1.12wks) and their newborns were studied during the expulsive stage of vaginal labor. Coaching consisted of standard recommendations for breathing including prolonged VMs coordinated with pushing. Maternal outcomes included the need for uterus fundal pressure maneuver and episiotomy, perineal trauma and posture. Neonatal outcomes included blood gases sampled from the umbilical cord, and Apgar scores. Data were analyzed with the Fisher's exact test, chi-square test, and Pearson correlation coefficient. RESULTS: None of the maternal outcomes were associated with VM duration. With respect to neonatal outcomes, increased VM duration was associated with reduced venous umbilical pH (r=-0.40; p=0.020), venous base excess (r=-0.42; p=0.014) and with arterial base excess (r=-0.36; p=0.043). Expulsive stage time was negatively associated with umbilical venous and arterial pH. CONCLUSIONS: VM duration during fetal expulsion in labor negatively affects fetal acid-base equilibrium and potentially the wellbeing of the neonate. Our results support the need to consider respiratory strategies during labor, to minimize potential risk to the mother and neonate.
publishDate 2011
dc.date.none.fl_str_mv 2011-02-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552011000100012
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552011000100012
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1413-35552011000100012
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
publisher.none.fl_str_mv Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
dc.source.none.fl_str_mv Brazilian Journal of Physical Therapy v.15 n.1 2011
reponame:Brazilian Journal of Physical Therapy
instname:Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia (ABRAPG-FT)
instacron:ABRAPG-FT
instname_str Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia (ABRAPG-FT)
instacron_str ABRAPG-FT
institution ABRAPG-FT
reponame_str Brazilian Journal of Physical Therapy
collection Brazilian Journal of Physical Therapy
repository.name.fl_str_mv Brazilian Journal of Physical Therapy - Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia (ABRAPG-FT)
repository.mail.fl_str_mv contato@rbf-bjpt.org.br||contato@rbf-bjpt.org.br
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