Key result
The Valsalva manoeuvre during labour affects various organ systems, and its avoidance through spontaneous pushing or instrumental delivery may be considered in women with specific medical conditions.
Why the study?
Valsalva manoeuvre during labour may exacerbate certain medical conditions leading to caesarean delivery, but alternative strategies exist and evidence regarding its organ system effects needed summarising.
What are the effects of the Valsalva manoeuvre on organ systems during labour, and how can it be managed in women with medical conditions?
What are the effects of the Valsalva manoeuvre on organ systems during labour, and how can it be managed in women with medical conditions?
This review highlights the physiological impacts of the Valsalva manoeuvre during labour and provides strategies to avoid it in women with vulnerable medical conditions, potentially avoiding unnecessary caesarean births.
Offers alternative to caesarean for Valsalva-sensitive conditions; leaves open prospective validation before changing delivery recommendations.
The Valsalva manoeuvre (VM) is a normal physiological event that occurs during the second active phase of labour. In women with medical conditions that may be exacerbated by the Valsalva, caesarean birth may be recommended. This carries with it its own potential for maternal morbidity, and thus it is important that women are appropriately counselled about the mode of delivery most suited to their individual situation. It is possible to avoid VM with spontaneous pushing rather than reverting to caesarean birth. Neuraxial analgesia and instrumental delivery may also be used to avoid prolonged VM. We outline the effect of VM on the various organ systems in pregnancy and summarise the available evidence on its implication.
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Keating et al. (2024) conducted a review in Labour and birth. Valsalva manoeuvre was evaluated. The Valsalva manoeuvre during labour affects various organ systems, and its avoidance through spontaneous pushing or instrumental delivery may be considered in women with specific medical conditions.
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