The Mueller-Hillis maneuver: can it be used to predict dystocia?

To assess prospectively the utility of intrapartum Mueller-Hillis maneuvers in predicting labor abnormalities.

Patients underwent Mueller-Hillis maneuvers upon admission in active labor. Outcomes of each labor were assessed, and correlations were sought between the degree of descent and outcome. Labor curves were constructed for each patient, and labor abnormalities were described by an observer blinded to descent and outcome. The relationship of labor abnormality to outcome also was evaluated.

One hundred six patients had Mueller-Hillis maneuvers performed. The distribution of results was as follows: no descent (N = 25) 23.6% one station (N = 33) 31.1%, two stations (N = 46) 43.4%, and three stations (N = 2) 1.9%. Lack of descent failed to indicate increased risk of abdominal delivery, operative vaginal delivery, need for oxytocin augmentation, prolonged second stage, or labor curve abnormality. Analysis of parity (nulliparous versus multiparous) did not alter these findings.

We present normative data for the results of Mueller-Hillis maneuvers performed in active labor. To our knowledge, no such data exist. We also failed to find a relationship between dystocia and descent with the maneuver. Until this test is demonstrated to be useful, it should not be used to predict dystocia.