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Database - Alliance francophone pour l'accouchement respecté (AFAR)

Description of this bibliographical database (AFAR website)
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https://afar.info/id=3028

Created on : 04 Nov 2018
Modified on : 26 Nov 2018

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Bibliographical entry (without author) :

L’expression abdominale durant la 2e phase de l’accouchement. Recommandations de bonne pratique. Haute Autorité de Santé, France.

Author(s) :

Haute Autorité de Santé, France

Year of publication :

2007

URL(s) :

https://www.has-sante.fr/portail/jcms/c_513170/fr/…

Résumé (français)  :

Synthèse des recommandations

• Il n’y a pas d’indications médicalement validées pour réaliser une expression abdominale.
• Le vécu traumatique des patientes et de leur entourage et l’existence de complications, rares mais graves, justifient l’abandon de cet usage.
• Dans les situations qui nécessitent d’écourter la 2e phase de l’accouchement, le recours, en fonction du contexte clinique, à une extraction instrumentale (forceps, ventouse obstétricale, spatules) ou à une césarienne est recommandé.
• Si une expression abdominale est pratiquée malgré les recommandations précédentes, elle doit être notée dans le dossier médical de la patiente par la personne en charge de l’accouchement, en précisant le contexte, les modalités de réalisation et les difficultés éventuellement rencontrées.

Abstract (English)  :

Summary of recommendations

• There are no medically validated indications for fundal pressure.
• The traumatic experience of patients and their entourage and the existence of complications, rare but serious, justify the abandonment of this use.
• In situations that necessitate shortening the second phase of delivery, the use of instrumental extraction (forceps, vacuum cups, spatulas) or caesarean section, depending on the clinical context, is recommended.
• If a fundal pressure is practiced despite the previous recommendations, it must be noted in the patient’s medical file by the person in charge of the delivery, specifying the context, the modalities of realization and the difficulties possibly encountered.

Sumário (português)  :

Resumo das recomendações

• Não existem indicações clinicamente validadas para expressão abdominal.
• A experiência traumática dos pacientes e sua comitiva e a existência de complicações, raras mas graves, justificam o abandono desse uso.
• Em situações que necessitem encurtamento da segunda fase do parto, recomenda-se o uso de extração instrumental (fórceps, aspiradores, espátulas) ou cesariana, dependendo do contexto clínico.
• Se uma expressão abdominal é praticada apesar das recomendações anteriores, deve ser anotada no prontuário do paciente pelo responsável pela entrega, especificando o contexto, as modalidades de realização e as dificuldades possivelmente encontradas.

Full text (public) :

Comments :

Cette RPC a été émise suite à une saisine du collectif CIANE (https://ciane.net).

Argument (français) :

Il n’y a pas d’indications médicalement validées pour réaliser une expression abdominale. Le vécu traumatique des patientes et de leur entourage et l’existence de complications, rares mais graves, justifient l’abandon de cet usage.

Argument (English):

There are no medically validated indications for fundal pressure. The traumatic experience of the patients and their entourage and the existence of complications, rare but serious, justify the abandonment of this use.

Argumento (português):

Não existem indicações clinicamente validadas para expressão abdominal. A experiência traumática dos pacientes e sua comitiva e a existência de complicações, raras mas graves, justificam o abandono desse uso.

Keywords :

➡ fundal pressure

Author of this record :

Bernard Bel — 04 Nov 2018
➡ latest update : Bernard Bel — 26 Nov 2018

Related records
#755   J.W. de Leeuw, P.C. Struijk, M.E. Vierhout, H.C.S. Wallenburg (2001). Risk factors for third degree perineal ruptures during delivery. BJOG: An International Journal of Obstetrics and Gynaecology. Vol. 108 Issue 4 Page 383 April 2001 ➡ https://afar.info/id=755
Pinned by #2993   Hofmeyr GJ, Vogel JP, Cuthbert A, Singata M (2017). Fundal pressure during the second stage of labour. Cochrane Database Syst Rev. 2017 ➡ https://afar.info/id=2993
Pinned by #2994   Furrer R, Schäffer L, Kimmich N, Zimmermann R, Haslinger C. (2016). Maternal and fetal outcomes after uterine fundal pressure in spontaneous and assisted vaginal deliveries. J Perinat Med. 2016 ➡ https://afar.info/id=2994
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