{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:49:27Z","timestamp":1780638567752,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Maternal pushing techniques during the second stage of labor may affect women's pelvic floor function. Our main objective was to assess the impact of the type of pushing used at delivery on the mother's medium\u2010term pelvic floor function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This is a secondary analysis of a randomized clinical trial (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>: NCT02474745) that took place in four French hospitals from 2015 through 2017 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0250). Women in labor with a singleton fetus in cephalic presentation at term who had undergone standardized training in both of these types of pushing were randomized after cervical dilation \u22657\u00a0cm. The exclusion criteria were a previous cesarean, a cesarean delivery in this pregnancy or a fetal heart rate anomaly. In the intervention group, open\u2010glottis (OG) pushing was defined as a prolonged exhalation contracting the abdominal muscles to help move the fetus down the birth canal. Closed\u2010glottis (CG) pushing was defined as Valsalva pushing. The principal outcome was the stage of pelvic organ prolapse (POP) assessed by the Pelvic Organ Prolapse\u2010Quantification 2\u00a0months after delivery. A secondary outcome was incidence of urinary incontinence (UI). The results of our multivariable, modified intention\u2010to\u2010treat analysis are reported as crude relative risks (RRs) with their 95% confidence intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our analysis included 207 women. Mode of birth was similar in both groups. The two groups did not differ for stage II POP: 10 of 104 (9.4%) in the OG group compared with 7 of 98 (7.1%) in the CG group, for a RR 1.32, 95% confidence interval [CI] 0.52\u20133.33, and an adjusted RR of 1.22, 95% CI 0.42\u20133.6. Similarly, the incidence of UI did not differ: 26.7% in the OG group and 28.6% in the CG group (aRR 0.81, 95% CI 0.42\u20131.53). Subgroup analysis suggests that for secundiparous and multiparous women, OG pushing could have a protective effect on the occurrence of UI (RR 0.33, 95% CI 0.13\u20130.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The type of directed pushing used at delivery did not impact the occurrence of pelvic organ prolapse 2\u00a0months after delivery. OG pushing may have a protective effect against UI among secundiparous and multiparous women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14461","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T06:38:29Z","timestamp":1668062309000},"page":"67-75","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Does the type of pushing at delivery influence pelvic floor function at 2\u2009months postpartum? A pragmatic randomized trial\u2014The EOLE study"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3611-8177","authenticated-orcid":false,"given":"Chlo\u00e9","family":"Barasinski","sequence":"first","affiliation":[{"name":"Centre National de la Recherche Scientifique, Institut Pascal Universit\u00e9 Clermont Auvergne, University Hospital Center Clermont\u2010Ferrand  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Debost\u2010Legrand","sequence":"additional","affiliation":[{"name":"Centre National de la Recherche Scientifique, Institut Pascal Universit\u00e9 Clermont Auvergne, University Hospital Center Clermont\u2010Ferrand  Clermont\u2010Ferrand France"},{"name":"Auvergne Perinatal Health Network  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Savary","sequence":"additional","affiliation":[{"name":"Hospital Center Arcachon  La Teste de Buch France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Bouchet","sequence":"additional","affiliation":[{"name":"University Hospital Center Clermont\u2010Ferrand  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Curinier","sequence":"additional","affiliation":[{"name":"University Hospital Center Clermont\u2010Ferrand  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"Vendittelli","sequence":"additional","affiliation":[{"name":"Centre National de la Recherche Scientifique, Institut Pascal Universit\u00e9 Clermont Auvergne, University Hospital Center Clermont\u2010Ferrand  Clermont\u2010Ferrand France"},{"name":"Auvergne Perinatal Health Network  Clermont\u2010Ferrand France"},{"name":"AUDIPOG (Association of Users of Computerized Records in Pediatrics, Obstetrics and Gynecology) RTH Laennec Medical 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