THE MODIFIED MUELLER-HILLIS MANEUVER IN PREDICTING ABNORMALITIES IN 2ND STAGE LABOR

Objective: To assess prospectively the utility of a modification of th e Mueller-Hillis maneuver in predicting abnormalities of the second st age of labor. Methods: The Mueller-Hillis maneuver was modified by lim iting its use to the second stage of labor during a contraction. The m aneuver was performed by one examiner; descent of 1 cm or more was dee med a positive maneuver. Descent less than 1 cm was deemed a negative maneuver. Labor outcomes were analyzed according to the results of thi s maneuver. Results: Seventy patients were enrolled in this study. Fif ty-one (72.9%) had greater than or equal to 1 cm descent maneuver and 19 (27.1%) had I 1 cm descent. A descent greater than or equal to 1 cm was significantly predictive of vaginal delivery (100%) and a descent less than or equal to 1 cm was significantly associated with an incre ased cesarean section rate (P = 0.001), prolonged second stage of labo r (P = 0.001), abnormal position (P = 0.01) and higher station (P = 0. 001). Conclusions: A positive modified Mueller-Hillis maneuver in seco nd stage labor had a high predictive value for vaginal delivery, where as a negative maneuver was significantly associated with high operativ e delivery rate, prolonged second stage labor and abnormal position. T hese results indicate that this modification of the Mueller-Hillis man euver needs to be considered for its utility in second stage labor.