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Pressing methods for the expulsion phase during birth

Eine schwangere Frau wird in Hamburg von einem Osteopathen vorgeburtlich betreut.
Pressing methods for the expulsion phase during birth

Übersicht der Pressmethoden

Powerpressen

bei jeder Presswehe tief Luft holen und während der gesamten Wehendauer pressen

spontanes Pressen

Frauen folgen ihren eigenen Instinkten, idR 3-5 mal/ Wehe.

verzögertes Pressen

Frauen pressen erst dann, wenn sie dem Pressdrang nicht mehr standhalten können oder wenn die Leitstelle den Damm erreicht hat.

Unterschiede der Pressmethoden

spontanes Pressen im Vergleich mit Powerpressen

Kaum Unterschiede

Verzögertes Pressen im Vergleich mit sofortigem Pressen (beide mit Epidural­anästhesie)

  • bei verzögertem Pressen Verlängerung der Austreibungsphase um etwa 56 Minuten (Evidenz niedrig)
  • Verzögern des Pressvorgangs bei Frauen mit Epiduralanästhesie verkürzt Pressdauer und erhöht Wahrscheinlichkeit einer spontanen vaginalen Entbindung
  • bei verzögertem Pressen häufiger niedriger pH-Wert des Nabelschnurbluts
Lemos et al 2017
 

ENGLISH VERSION:
Pressing methods for the expulsion phase of birth

Power pushing

take a deep breath with each contraction and push for the entire duration of the contraction.

Spontaneous pushing

Women follow their own instincts, usually 3-5 times per contraction.

Delayed pushing

Women push only when they can no longer withstand the urge to push or when the control centre has reached the perineum.

Differences in Pressing methods

spontaneous pushing compared with power pushing

Hardly any differences

Delayed pushing compared with immediate pushing (both with epidural anaesthesia)

  • Delayed pushing prolongs the expulsion phase by about 56 minutes (evidence low).
  • Delayed pushing in women with epidural anaesthesia reduces duration of pushing and increases likelihood of spontaneous vaginal delivery.
  • Delayed pushing more likely to result in low pH of cord blood.
Lemos et al 2017
 

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