The effect of uterine fundal pressure on the duration of the second stage of labor: a randomized controlled trial.

OBJECTIVE: To determine the effect of uterine fundal pressure on shortening the second stage of labor and on the fetal outcome.

DESIGN: Randomized controlled trial.

SETTING: Teaching and research hospital.

SAMPLE: One hundred ninety-seven women between 37 and 42 gestational weeks with singleton cephalic presentation admitted to the delivery unit.

METHODS: Random allocation into groups with or without manual fundal pressure during the second stage of labor.

MAIN OUTCOME MEASURES: The primary outcome measure was the duration of the second stage of labor. Secondary outcome measures were umbilical artery pH, HCO3-, base excess, pO2, pCO2 values and the rate of instrumental delivery, severe maternal morbidity/mortality, neonatal trauma, admission to neonatal intensive care unit, and neonatal death.

RESULTS: There were no significant differences in the mean duration of the second stage of labor and secondary outcome measures except for mean pO2 which was lower and mean pCO2 which was higher in the fundal pressure group. Nevertheless, the values still remained within normal ranges and there were no neonates with an Apgar score <7 in either of the groups.

CONCLUSION: Application of fundal pressure on a delivering woman was ineffective in shortening the second stage of labor.