Uterine artery hemodynamic changes due to a Cervical Traction maneuver (Amr’s maneuver); Randomized Controlled Study

Abstract

Aim: This study aimed to measure the impacts of cervical traction on the uterine artery hemodynamics.Materials and Methods: This study was a randomized-controlled trial. The primary outcome measure was the uterine artery hemodynamics indices: end diastolic velocity (EDV) and systolic/diastolic velocity ratio (S/D ratio).Results: The study was conducted in one institution in Cairo from January-2017 to March-2017 with 12-month follow up period. Both groups were comparable (p-value > 0.05) with regard to the age, BMI, heart rate, blood pressure, gravidity, parity as well as episiotomy. There was no difference (P> 0.05) between the two groups regarding vital signs after the intervention. All the patients tolerated the procedure with mild sedation. PSV, EDV, S/D, PI and RI were comparable between both groups before the intervention. However, PSV, S/D ratio, RI and PI were significantly higher (p-values < 0.001) in the study group than the control group after the intervention. On the other hand, EDV was significantly lower in the study group than the control group after the intervention (p-value < 0.001). During the follow-up period, no adverse events reported.Conclusion: Amr’s maneuver is effective in changing the uterine artery hemodynamics indices in the direction of decreasing the uterine artery blood flow.