SynthesisEuropean journal of obstetrics, gynecology, and reproductive biology2022
Fundal pressure to shorten the second stage of labor: Systematic review and meta-analysis.
Synthesis in European journal of obstetrics, gynecology, and reproductive biology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 6 citations in OpenAlex.
- Gentle fundal pressure to facilitate vaginal delivery: A randomized clinical trial.Acta obstetricia et gynecologica Scandinavica · 2025Trial
- A comparison in maternal and neonatal outcomes between mild fundal pressure and vacuum extraction for shortening the second stage of labor.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Letter to the editor: A comparison in maternal and neonatal outcomes between mild fundal pressure and vacuum extraction for shortening the second stage of labor-Reconsidering the use of the term "mild fundal pressure" in obstetric practice.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Article
- Making sense of fundal pressure: A qualitative study on women's experiences of a non-evidence-based yet commonly practiced intervention.Archives of gynecology and obstetrics · 2025Article
- Does a longer second stage of labor worsen umbilical artery blood gas parameters in newborns?-a retrospective cohort study of 2,140 cases.Annals of translational medicine · 2022Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSystematically review the evidence on fundal pressure to expedite vaginal delivery. STUDY
designLiterature search in electronic databases. Randomized controlled trials of fundal pressure to expedite delivery were included in this systematic review and meta-analysis. The primary outcome was the length of the second stage.
resultsWe identified 10 randomized controlled trials. Fundal pressure was associated with a shorter length of the second stage of labor (mean difference (MD) -20.33 min, 95% confidence intervals (CI) -28.55, -12.11). Sub-group analysis with only manual pressure or a belt confirmed the association. There was no significant difference in the rate of vaginal delivery (relative risk (RR) 1.00, 95%, CI 0.98, 1.02), one and five minute Apgar scores (MD 0.10, 95%, confidence intervals -0.05, 0.24; and MD 0.02, 95%, CI -0.12, 0.15), neonatal trauma (RR 0.33, 95%, CI 0.01, 7.90), vaginal/perineal laceration (RR 0.83, 95%, CI 0.57, 1.22), cervical laceration (RR 1.30, 95%, CI 0.21, 8.02), episiotomy (RR 1.08, 95%, CI 0.96, 1.21), cesarean section rate (RR 0.72; 95%, CI 0.34, 1.51), operative vaginal deliveries (RR 0.79; 95%, CI 0.55, 1.13) and neonatal intensive care admissions (RR 0.33, 95%, CI 0.01, 7.90). However, patients receiving fundal pressure had a lower umbilical cord arterial pH (MD -0.03, 95%, CI -0.04, -0.01), and a 3.5 non-significantly higher incidence of Apgar scores < 7 at 5 min (4.9% vs 0.7%, RR 3.48, 95%, CI 0.57, 21.32).
conclusionsFundal pressure in the second stage is associated with a 20-minute decrease in the length of labor and a small decrease in neonatal umbilical artery pH.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.