Fundal Pressure

Specialties Ob/Gyn

Published

:confused: I would like any input that you have on fundal pressure. Do it? Don't do it? Do it under certain circumstances? Does anyone have a specific policy r/t fundal pressure? I would love to know what you think and what your policy is! Thanks!

Fundal pressure for C/S, but only suprapubic pressure for shoulders.

We do occasionally do mild fundal pressure to keep the baby's head from retreating back in between pushes when the mom is getting tired or a baby needs to get on out of there in a timely fashion. I've not seen this cause problems. If anything, it has helped. But it is done sparingly, carefully & wisely.

Up Vote Up Vote ×
Specializes in midwifery, NICU.
what about fundal pressure after the baby is delivered to help with the placenta coming out? Is that bad to do also?

No, still no pressure used, but palpation and v gentle massage of the fundus, if the placenta is adhering. The massage often helps and you feel that hard ball under your hand. Mega awareness of the risk of uterine inversion and PPH is required.

Up Vote Up Vote ×
Specializes in midwifery, NICU.
If you use fundal pressure and the outcome is not a perfect delivery you can bet that it will add a better opportunity for a money hungry lawyer to make an easier case. Fundal pressure was used in the US I think up into the 80's then forbidden.

They use it over here in Europe very frequently. Sometimes applying a sheet across the fundus and having two people pull w/ full weight (this is a terribly way to speed up a delivery).

Risks are what have been already mentioned, bad tears if the person applying it doesn't stop at the right time, invertion of uterus, fetal trauma. Here they use it before vacuum or forceps. A firend told me of a lady who was 4-5cm and had decels. There was not a doc on to do a crash c/s, They manual dilated here to

complete and delivered the baby in about 20 minutes.

When you are checking stress effects on a cervix a little fundal pressure can be useful. Sometimes a little fundal pressure may not hurt anything during delivery- you can yank from one end w/ a vacuum or forceps. Pushing on the fundus may serve a similar effect but since it is criticised in the US dont use it to facilitate delivery.

J

Kennedy..where are you in Europe, where you find this happening so frequently??? Have never seen anything like you describe happening here in the UK! Horror story with the sheet thing etc!

Up Vote Up Vote ×
+ Add a Comment