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The modified Mueller-Hillis maneuver in predicting abnormalities in second stage labor
M R March1, C D Adair, J C Veille
1Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC, USA.
Summary
A modified Mueller-Hillis maneuver effectively predicts labor outcomes. A positive result indicates likely vaginal delivery, while a negative result suggests increased risk of cesarean delivery and prolonged labor.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- The second stage of labor can present complications.
- Predictive tools are valuable for managing labor and delivery.
Purpose of the Study:
- To prospectively evaluate a modified Mueller-Hillis maneuver for predicting second-stage labor abnormalities.
- To assess the maneuver's utility in identifying patients at risk for operative delivery or prolonged labor.
Main Methods:
- Modified Mueller-Hillis maneuver performed during contractions in the second stage of labor.
- A descent of 1 cm or more was considered a positive maneuver; less than 1 cm was negative.
- Labor outcomes were analyzed based on maneuver results in 70 patients.
Main Results:
- A positive maneuver (≥1 cm descent) predicted 100% vaginal delivery.
- A negative maneuver (<1 cm descent) was significantly associated with increased cesarean section rates (P=0.001).
- Negative maneuvers also correlated with prolonged second stage (P=0.001), abnormal position (P=0.01), and higher fetal station (P=0.001).
Conclusions:
- The modified Mueller-Hillis maneuver demonstrates high predictive value for vaginal delivery.
- A negative maneuver is a significant indicator of potential operative delivery, prolonged labor, and abnormal fetal positioning.
- This modified maneuver warrants consideration for its clinical utility in managing the second stage of labor.