Trial reportActa obstetricia et gynecologica Scandinavica2025
Gentle fundal pressure to facilitate vaginal delivery: A randomized clinical trial.
Trial report in Acta obstetricia et gynecologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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, 1 synthesis or guideline pooled it.
- Comparative effectiveness of physical interventions for preventing perineal trauma during vaginal delivery: a systematic review and Bayesian network meta-analysis.Frontiers in medicine · 2026Pooled it
- 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
- Response: 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
- 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-Fundal pressure maneuvers are not created equal.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Kristeller misunderstood?Acta obstetricia et gynecologica Scandinavica · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFundal pressure during the second stage of labor is widely practiced but understudied. Violent fundal pressure can cause maternal and fetal injuries. Many providers believe the maneuver is effective. Administrative efforts to ban fundal pressure are unsuccessful and only drive the procedure to an underground practice. MATERIAL AND
methodsIn this single-center, open-label, randomized trial, nulliparous women with term singleton cephalic pregnancy under epidural analgesia were assigned to receive gentle manual fundal pressure (GMFP) or routine labor care. The GMFP was designed not to exceed a maximum of 120 mmHg. Women were randomized after 30 min of pushing in the second stage of labor. The primary outcome was the time from randomization to delivery. Secondary outcomes were mode of delivery, episiotomy, perineal laceration, cord blood pH, and other maternal and fetal outcomes.
resultsBetween July 2023 and January 2024, 164 women were randomized to GMFP (n = 82) or to routine care (n = 82). The time from randomization to vaginal delivery did not show statistical significance between the fundal pressure group and the control group (mean [SD], 46.3 [33.3] vs. 55.9 [45.8] min; p = 0.13). Significantly fewer women in the fundal pressure group had operative vaginal deliveries (4 of 82 [4.9%]) than women in the control group (13 of 82 [15.9%]; relative risk [RR] 0.308, 95% confidence interval [CI] 0.105-0.904; p = 0.021). Similarly, mediolateral episiotomy was performed in fewer women in the fundal pressure group (6 of 82 [7.32%]) than in the control group (16 of 82 [19.51%], RR 0.375, 95% CI 0.154-0.910; p = 0.022). Other maternal and fetal outcomes were similar in the two groups.
conclusionsGMFP resulted in a nonsignificant reduction in the second stage of labor and a significant reduction in operative vaginal delivery and episiotomy without an increase in adverse outcomes. Fundal pressure during the second stage of labor deserves further investigation.
Indexed as
Identifiers
What OpenQuestion holds
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.