Which of the following maneuvers applies pressure to the closed glottis and is a technique used to assist in labor?

Appeared in: BTSC Staff Nurse 31 July-2025

Explanation

The Valsalva maneuver is defined as a forceful attempt at exhalation against a closed airway, which is achieved by closing the glottis.
This action increases pressure within the thoracic and abdominal cavities.
In the context of labor, this increased pressure is used to supplement uterine contractions and aid in the expulsion of the fetus during the second stage.
It is a technique of 'closed-glottis' pushing, where the laboring woman holds her breath and bears down.

Option A: The Mauriceau maneuver is a specific technique for delivering the head in a breech presentation, not a general method for assisting labor by increasing pressure.
Option B: The Zavanelli maneuver is an emergency procedure to resolve severe shoulder dystocia by pushing the fetal head back into the uterus for a cesarean delivery. It is the opposite of assisting with delivery.
Option C: Heimlich's maneuver is an emergency procedure for choking and is unrelated to labor and delivery.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Obstetric Maneuvers as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in coaching laboring women on pushing techniques. Understanding the risks of the Valsalva maneuver (e.g., reduced uteroplacental blood flow, fetal hypoxia, increased maternal fatigue) is vital.
Modern practice often favors open-glottis pushing (exhaling while pushing) to minimize these risks and promote better oxygenation for the mother and baby.
Patient safety involves educating the mother on different pushing styles and supporting her choice while monitoring fetal well-being closely.

How to Approach the Question

First, analyze the question to identify the key components: a maneuver that (1) applies pressure to a closed glottis and (2) is used to assist in labor.
Define each of the options provided.
The 'Valsalva maneuver' involves exhaling against a closed airway, which directly matches the 'closed glottis' part of the question.
The 'Mauriceau maneuver' is for breech births.
The 'Zavanelli maneuver' is for shoulder dystocia emergencies.
The 'Heimlich maneuver' is for choking.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 28-46

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 17-25

Practise the full BTSC Staff Nurse 31 July-2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.