{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:21:18Z","timestamp":1783444878824,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Fundal pressure (FP), a controversial obstetric maneuver due to its potential benefits and risks, lacks robust evidence concerning its effects. This study aimed to evaluate the maternal and neonatal outcomes associated with the application of FP during the second stage of labor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following our departmental protocol, FP is applied by obstetricians trained under the supervision of the head of the labor ward. Its implementation requires patient consent and documentation. This case\u2013control study encompassed vaginal deliveries (VDs) involving FP (FP group) during the second stage of labor. The control group included subsequent deliveries matched 1:1 for gestational age, parity, and mode of delivery (vacuum extraction [VE] or VD). Maternal and neonatal outcomes were compared between the groups. Composite adverse outcomes included the presence of at least one of the following: grade 3\u20134 perineal tear, shoulder dystocia, postpartum hemorrhage, postpartum hospitalization exceeding 4\u2009days, or postpartum use of analgesics exceeding five doses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 12\u2009048 deliveries during the 3\u2010year study period, 325 (2.7%) involved FP. There were no significant differences in maternal age, body mass index, or gestational age between the FP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009325) and control groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009325). However, the FP group exhibited higher rates of labor induction (41.5% vs. 19.3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), oxytocin augmentation (52% vs. 23.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), and prolonged duration of the second stage of labor (1.88\u2009\u00b1\u20091.2 vs. 1.57\u2009\u00b1\u20091.3\u2009h,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003). There were no significant differences in the rate of postpartum hemorrhage, composite adverse maternal outcomes, or early neonatal outcomes between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fundal pressure, when administered by trained obstetricians, was not associated with adverse obstetric, maternal, or neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70218","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T05:04:47Z","timestamp":1747371887000},"page":"743-749","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["\u201cFirst do no harm\u201d: Fundal pressure during labor\u2014How safe is it?"],"prefix":"10.1002","volume":"171","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6461-3557","authenticated-orcid":false,"given":"O.","family":"Eliner","sequence":"first","affiliation":[{"name":"Meir Medical Center  Kfar Saba Israel"},{"name":"School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kovo","sequence":"additional","affiliation":[{"name":"Meir Medical Center  Kfar Saba Israel"},{"name":"School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Semo","sequence":"additional","affiliation":[{"name":"School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Yacobi","sequence":"additional","affiliation":[{"name":"Bruce Rappaport Faculty of Medicine Technion Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Brodsky","sequence":"additional","affiliation":[{"name":"Department of Molecular Genetics Weizmann Institute of Science  Rehovot Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Biron","sequence":"additional","affiliation":[{"name":"Meir Medical Center  Kfar Saba Israel"},{"name":"School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Shechter Maor","sequence":"additional","affiliation":[{"name":"Meir Medical Center  Kfar Saba Israel"},{"name":"School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12284"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-021-01148-1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04523-x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006067.pub3"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1277699"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.15462"},{"key":"e_1_2_11_8_1","volume-title":"WHO recommendations: Intrapartum care for a positive childbirth experience","year":"2018"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12424"},{"key":"e_1_2_11_10_1","first-page":"67","article-title":"ACOG practice bulletin No. 33: Diagnosis and management of 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