Our director doesn't believe fundal pressure is contraindicated?????

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Hi,

I am asking for help from the group. Recently, there was an incident involving fundal pressure during a lady partsl delivery provided by an unlicensed nursing assistant at the doctors request. Unfortunately, our director and others in a position of authority, refuse to believe the labor nurse's position that fundal pressure is contraindicated. We decided to get some evidence...and guess what...we can't find any. I have read the threads here and many RN's state clearly that it is NOT OK to do fundal pressure. I need hard evidence that I can bring to the higher ups and don't know where to get it. AWHONN costs $$$$$ to get this info maybe?? Not sure. Does anyone have anything that can help me??

Thank you!

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Specializes in Med/Surg, Ortho, ASC.

Here's a thread that I found (not that it's 'evidence'):

https://allnurses.com/ob-gyn-nursing/fundal-pressure-254837.html

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You can search PubMed. The website is:

http://www.ncbi.nlm.nih.gov/sites/entrez

I searched using "fundal pressure."

Hope this helps.

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found on pub med... one of many...

arch gynecol obstet. 2009 nov;280(5):781-6. epub 2009 mar 5.

use of uterine fundal pressure maneuver at lady partsl delivery and risk of severe perineal laceration.

matsuo k, shiki y, yamasaki m, shimoya k.

department of obstetrics, gynecology, and reproductive sciences, university of maryland school of medicine, 22 south greene street, po box 290, baltimore, md 21201, usa. [email protected]

objective: owing to the lack of evidence supporting the use of uterine fundal pressure maneuver in lady partsl delivery, the role of the maneuver is undetermined and remains controversial. the aim of this study was to identify the prone factor of the use of uterine fundal pressure maneuver and to evaluate its obstetrical outcomes. methods: all lady partsl delivery records between 1 january 2005 and 30 april 2006 were evaluated. maternal and neonatal variables and obstetrical complications were analyzed for subjects underwent uterine fundal pressure maneuver. results: six hundred sixty-one lady partsl deliveries were evaluated. fundal pressure maneuver was performed in 39 cases (5.9%, 95% ci 4.4-7.1). primiparity (76.9 vs. 53.3%; odds ratio 2.92, 95% ci 1.36-6.25, p = 0.004), larger maternal body weight gain during pregnancy (11.16 +/- 0.4 kg vs. 10.05 +/- 0.16 kg, p = 0.013), and longer duration of labor (922.3 +/- 111.7 vs. 566.6 +/- 18.3 min, p = 0.003) were prone risk factors for the use of uterine fundal pressure maneuver at lady partsl delivery. one case of shoulder dystocia following uterine fundal pressure maneuver was reported (2.5 vs. 0%). episiotomy (76.9 vs. 44.9%, p

pmid: 19263062 [pubmed - in process]

their conclusion supports your position...

dave

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Specializes in ER,Med-surg,tele,postpartum.

wow this is amazing Im not an experienced L and D nurse , been a nurse for 15 years and never heard that NA's can do this .... Can you work at a different facility , thats scary !!!!!!!! I do remember RN's doing it but wow scary !!!!>

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Specializes in Ante-Intra-Postpartum, Post Gyne.

It is not recommended on a regular basis; but I have heard of it being done on a few rare occasions when the baby was stuck and needed to come out RIGHT NOW.

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Wow, never knew it was contraindicated. Can you tell I am still young in my career and work in a place that doesn't know any better.

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