Document Detail

What's a proper push? The Valsalva manoeuvre revisited.
MedLine Citation:
PMID:  22540174     Owner:  NLM     Status:  Publisher    
In daily practice, the Valsalva manoeuvre is used to assess pelvic organ prolapse, virtually always without standardisation of pressure. We undertook a study to determine maximum pressures reached and pressures required to obtain 80% of maximal pelvic organ descent, to investigate the need for such standardisation. Clinical data and ultrasound data sets of 75 women seen for urodynamic testing were reviewed retrospectively, with three Valsalva manoeuvres registered per patient. Maximum rectal pressures generated during Valsalva were 107 cm H (2) O on average (range, 45-190 cm H (2) O). Ninety-seven percent of all women managed to reach pressures ≥60 cm H (2) O. On average, 80% of maximal bladder neck descent was reached at 56 cm H (2) O, 80% of maximal pelvic organ descent at 38 cm H (2) O. Our results imply that virtually all patients were able to generate pressures resulting in ≥80% of maximal pelvic organ descent. This implies that standardisation of Valsalva pressures for prolapse assessment may be unnecessary.
Femke E M Mulder; Ka L Shek; Hans P Dietz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-29
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  -     ISSN:  1479-828X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands.
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