[Ritgen maneuver and its modifications]

Abstract

Objective: To present the Ritgen maneuver, its original description as well as its most common modifications and to demonstrate the heterogenity of descriptions of the maneuver regarding its performance, purpose and published results.

Design: A review article.

Setting: Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Pilsen, Charles University in Prague.

Methods: A review article demonstrating the heterogeneity of Ritgen maneuver descriptions based on analysis of present and past obstetrical textbooks and journal articles.

Conclusion: At present there is a pursuit of finding and analysis of methods for obstetric perineal injury prevention, which could considerably improve quality of life of women after delivery. One of the possible mechanisms of perineal trauma reduction is to ensure that the fetal head passes with its smallest head circumference through the perineal structures. Already in the middle of the 19th century, von Ritgen devised a method allowing to facilitate and control the extension of the fetal head in the end of the second stage of labor. His method quickly spread all over the world, however, the description changed considerably. The Ritgen maneuver today means a variety often very different interventions. This review points out to the need of clarification of terminology, i.e. definition and classification of methods facilitating extension of the fetal head in the end of the second stage of labor.