Do maternal pushing techniques during labour affect obstetric or neonatal outcomes?

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Perinatal Research

Background:

• Pushing techniques during the second stage of labor can vary.
• The impact of different pushing methods on maternal and neonatal well-being is not fully understood.

Purpose of the Study:

• To conduct a literature review assessing maternal and neonatal morbidity linked to pushing techniques during the second stage of labor.

Main Methods:

• Searched Cochrane Library and Medline for randomized controlled trials (1980-2015).
• Keywords included "delivery", "birth", "pushing", "second stage of labor", "randomised controlled trials", and "meta-analysis".

Main Results:

• Seven randomized controlled trials were identified.
• No significant differences were observed in perineal injuries, episiotomies, or birth type between groups.
• Pelvic floor structure impact varied; one study showed improved Apgar scores and umbilical artery pH with "open glottis" pushing.

Conclusions:

• Low methodological quality and protocol variations limit recommendations for specific pushing techniques.
• Further research is necessary to evaluate outcomes associated with different pushing methods in labor.