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Related Experiment Videos

Pushing in labor: performance and not endurance.

Catalin S Buhimschi1, Irina A Buhimschi, Andrew M Malinow

  • 1Department of Obstetrics, Gynecology and Reproductive Sciences, the University of Maryland School of Medicine, Baltimore, USA.

American Journal of Obstetrics and Gynecology
|June 18, 2002
PubMed
Summary

Maternal pushing performance during labor is influenced by body mass index, fetal weight, and myometrial thickness. These factors can predict a woman's ability to increase intrauterine pressure effectively during the second stage of labor.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Labor and Delivery

Background:

  • The second stage of labor, or expulsion phase, exhibits significant duration variability.
  • Clinicians often attribute rapid delivery to patient cooperation or epidural anesthesia strength.
  • Factors influencing maternal pushing performance remain incompletely understood.

Purpose of the Study:

  • To investigate maternal, fetal, and labor characteristics impacting maternal pushing performance.
  • To develop a predictive index for identifying high versus low pushing performers.
  • To understand the relationship between pushing efforts and intrauterine pressure (IP) increase.

Main Methods:

  • Prospective measurement of intrauterine pressure (IP) during the second stage of labor in 52 women.

Related Experiment Videos

  • Standardized closed-glottis pushing technique in women receiving epidural anesthesia.
  • Multivariate linear regression analysis to identify predictors of IP increase.

    • Main Results:

    • Maternal pushing increases intrauterine pressure (IP) by an average of 62%.
    • Individual increases in IP ranged from 0% to 192%.
    • A predictive model incorporating myometrial thickness, estimated fetal weight, maternal BMI, and need for labor augmentation accurately predicted pushing performance (r = 0.52).

    Conclusions:

    • Maternal pushing efficiency is directly related to body mass index.
    • Pushing efficiency is inversely related to myometrial thickness, estimated fetal weight, and the need for labor augmentation.
    • Myometrial thickness was the strongest predictor of pushing performance.