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Currently 3111 records
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https://ciane.net/id=3014

Created on : 22 Aug 2018
Modified on : 04 Nov 2018

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Bibliographical entry (without author) :

The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition. Rev Bras Fisioter. 2011 Jan-Feb;15(1):66-72.

Author(s) :

Lemos A, Dean E, de Andrade AD.

Year of publication :

2011

URL(s) :

https://www.ncbi.nlm.nih.gov/pubmed/21519717

Résumé (français)  :

OBJECTIFS:
Cette étude transversale a été conçue pour examiner les effets de la manœuvre de Valsalva (VM) et sa durée sur l’équilibre acido-basique du nouveau-né et ses répercussions maternelles au stade expulsif du travail, après des instructions de respiration et de poussée standard.

Méthodes:
Un échantillon de femmes à faible risque de grossesse (n = 33; âge moyen 22,5 ± 3,7 ans et âge gestationnel 38,1 ± 1,1 semaines) et leurs nouveau-nés ont été étudiés au stade expulsif du travail. Le coaching consistait en des recommandations standard pour la respiration, y compris des VM prolongées coordonnées avec la poussée. Les résultats maternels incluaient la nécessité d’une manœuvre d’expression abdominale et d’une épisiotomie, d’un traumatisme périnéal et d’une posture imposée. Les résultats néonataux comprenaient les gaz sanguins prélevés dans le cordon ombilical et les scores d’Apgar. Les données ont été analysées avec le test exact de Fisher, le test du Khi-deux et le coefficient de corrélation de Pearson.

RÉSULTATS:
Aucun des résultats maternels n’était associé à la durée de VM. En ce qui concerne les résultats néonataux, une augmentation de la durée de VM était associée à un pH ombilical veineux réduit (r = -0,40; p = 0,020), un excès de base veineux (r = -0,42; p = 0,014) et un excès de base artériel (r = -0,36 ; p = 0,043). La phase expulsive était associée négativement au pH veineux et artériel ombilical.

CONCLUSIONS:
La durée de VM durant l’expulsion du fœtus pendant le travail affecte négativement l’équilibre acide-base fœtal et potentiellement le bien-être du nouveau-né. Nos résultats appuient la nécessité d’envisager des stratégies respiratoires pendant le travail afin de minimiser les risques potentiels pour la mère et le nouveau-né.

Abstract (English)  :

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±3.7 y and gestational age 38.1±1.12 wks) 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.

Sumário (português)  :

OBJETIVOS:
Este estudo transversal foi desenhado para examinar os efeitos da Manobra de Valsalva (VM) e sua duração no equilíbrio ácido-base do recém-nascido e suas repercussões maternas durante o período expulsivo do trabalho de parto, após as instruções padrão de respiração e empurrão.

MÉTODOS:
Uma amostra de conveniência de mulheres com gravidez de baixo risco (n = 33; idade média de 22,5 ± 3,7 anos e idade gestacional de 38,1 ± 1,12 semanas) e seus recém-nascidos foi estudada durante o período expulsivo do trabalho vaginal. O coaching consistia em recomendações padrão para respiração, incluindo VMs prolongadas coordenadas com o empurrão. Os desfechos maternos incluíram a necessidade de manobra de pressão funda do útero e episiotomia, trauma perineal e postura. Os resultados neonatais incluíram os gases sanguíneos amostrados do cordão umbilical e os escores de Apgar. Os dados foram analisados ​​com o teste exato de Fisher, teste qui-quadrado e coeficiente de correlação de Pearson.

RESULTADOS:
Nenhum dos resultados maternos foi associado à duração da VM. Com relação aos desfechos neonatais, o aumento do tempo de VM esteve associado à redução do pH umbilical venoso (r = -0,40; p = 0,020), excesso de base venosa (r = -0,42; p = 0,014) e com excesso de base arterial (r = -0,36 p = 0,043). Tempo de estágio expulsivo foi associado negativamente com o pH venoso e arterial umbilical.

CONCLUSÕES:
A duração da VM durante a expulsão fetal no trabalho de parto afeta negativamente o equilíbrio ácido-básico fetal e potencialmente o bem-estar do neonato. Nossos resultados apóiam a necessidade de considerar estratégias respiratórias durante o trabalho de parto, para minimizar o risco potencial para a mãe e o neonato.

Resumen (español)  :

Full text (public) :

Comments :

Argument (français) :

La durée de manœuvre de Valsalva (https://fr.wikipedia.org/wiki/Manœuvre_de_Valsalva) durant l’expulsion du fœtus pendant le travail affecte négativement l’équilibre acide-base fœtal et potentiellement le bien-être du nouveau-né.

Argument (English):

Valsalva Maneuver (https://en.wikipedia.org/wiki/Valsalva_maneuver) duration during fetal expulsion in labor negatively affects fetal acid-base equilibrium and potentially the wellbeing of the neonate.

Argumento (português):

O tempo de manobra de Valsalva (https://pt.wikipedia.org/wiki/Manobra_de_Valsalva) durante a expulsão do feto durante o trabalho de parto afeta negativamente o equilíbrio ácido-base fetal e potencialmente o bem-estar do recém-nascido.

Argumento (español):

Keywords :

➡ iatrogeny ; baby’s health ; fetal distress ; episiotomy ; fundal pressure

Author of this record :

Alison Passieux — 22 Aug 2018
➡ latest update : Bernard Bel — 04 Nov 2018

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