The prevalence of uterine fundal pressure during the second stage of labour for women giving birth in health facilities: a systematic review and meta-analysis

Uterine fundal pressure involves a birth attendant pushing on the woman's uterine fundus to assist vaginal birth. It is used in some clinical settings, though guidelines recommend against it. This systematic review aimed to determine the prevalence of uterine fundal pressure during the second s...

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Bibliographic Details
Published in:Reproductive health 2021-05, Vol.18 (1), p.98-17, Article 98
Main Authors: Farrington, Elise, Connolly, Mairead, Phung, Laura, Wilson, Alyce N, Comrie-Thomson, Liz, Bohren, Meghan A, Homer, Caroline S E, Vogel, Joshua P
Format: Article
Language:English
Subjects:
Abdomen
Childbirth & labor
Delivery, Obstetric - adverse effects
Delivery, Obstetric - methods
Delivery, Obstetric - statistics & numerical data
Fallopian tubes
Female
Fundal pressure
Health Facilities
Humans
Intrapartum care
Kristeller maneuver
Labor (Obstetrics)
Labor Stage, Second - physiology
Labour and childbirth
Maternal child nursing
Maternal mortality
Meta-analysis
Mistreatment during childbirth
Obstetrics - methods
Physiological aspects
Pregnancy
Pressure
Prevalence
Quality of care
Quality of Health Care
Reproductive health
Review
Systematic review
Uterus
Vagina
Women
Womens health
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Summary:Uterine fundal pressure involves a birth attendant pushing on the woman's uterine fundus to assist vaginal birth. It is used in some clinical settings, though guidelines recommend against it. This systematic review aimed to determine the prevalence of uterine fundal pressure during the second stage of labour for women giving birth vaginally at health facilities. The population of interest were women who experienced labour in a health facility and in whom vaginal birth was anticipated. The primary outcome was the use of fundal pressure during second stage of labour. MEDLINE, EMBASE, CINAHL and Global Index Medicus databases were searched for eligible studies published from 1 January 2000 onwards. Meta-analysis was conducted to determine a pooled prevalence, with subgroup analyses to explore heterogeneity. Eighty data sets from 76 studies (n = 898,544 women) were included, reporting data from 22 countries. The prevalence of fundal pressure ranged from 0.6% to 69.2% between studies, with a pooled prevalence of 23.2% (95% CI 19.4-27.0, I  = 99.97%). There were significant differences in prevalence between country income level (p 
ISSN:1742-4755
1742-4755
DOI:10.1186/s12978-021-01148-1