THE MUELLER-HILLIS MANEUVER - CAN IT BE USED TO PREDICT DYSTOCIA

Objective: To assess prospectively the utility of intrapartum Mueller- Hillis maneuvers in predicting labor abnormalities. Methods: Patients underwent Mueller-Hillis maneuvers upon admission in active labor. Out comes of each labor were assessed, and correlations were sought betwee n the degree of descent and outcome. Labor curves were constructed for each patient, and labor abnormalities were described by an observer b linded to descent and outcome. The relationship of labor abnormality t o outcome also was evaluated. Results: One hundred six patients had Mu eller-Hillis maneuvers performed. The distribution of results was as f ollows: no descent (N = 25) 23.6%, one station (N = 33) 31.1%, two sta tions (N = 46) 43.4%, and three stations (N = 2) 1.9%. Lack of descent failed to indicate increased risk of abdominal delivery, operative va ginal delivery, need for oxytocin augmentation, prolonged second stage , or labor curve abnormality. Analysis of parity (nulliparous versus m ultiparous) did not alter these findings. Conclusion: We present norma tive data for the results of Mueller-Hillis maneuvers performed in act ive labor. To our knowledge, no such data exist. We also failed to fin d a relationship between dystocia and descent with the maneuver. Until this test is demonstrated to be useful, it should not be used to pred ict dystocia.