Fundal Pressure During the Second Stage of Labor (Kristeller Maneuver): A Critical Appraisal of Its Potential Role in the Modern Obstetrics

Fundal pressure in the second stage of labor, also known as Kristeller maneuver, gets the name from its creator, Samuel Kristeller, who was born in Poland in 1820 and died in Berlin in 1900 [1] (Fig. 54.1). In 1867, Kristeller published a study in which he described an obstetric maneuver that could help women in the second stage of labor to push out the fetus by pressing many times the uterus for a short time toward the horizontal axis of the birth canal [1]. In the original procedure, the patient laid in supine position, and the operator placed his hands on the fundus and sides of the uterus. Combining downward pressure with the palms on the fundus with lateral pressure by means of the fingers, the uterus was brought into correct relation with the pelvic axis, and the fetus was forced down into the canal of birth [2].