Uterine rupture after the uterine fundal pressure maneuver

To clarify the incidence of uterine fundal pressure at delivery and its effect on uterine rupture.

A questionnaire was sent to 2518 institutions in Japan. We received a response from 1430.

Of reporting institutions, 89.4% used fundal pressure in at least some of their deliveries. Among the 347,771 women who delivered vaginally in this study, 38,973 (11.2%) were delivered with the assistance of fundal pressure. There were six cases of uterine rupture associated with uterine fundal pressure, with one case resulting in maternal death secondary to amniotic fluid embolism.

Since uterine fundal pressure may potentially cause serious injury to either the mother and/or neonates, the indications for application need to be clearly elucidated, and obstetric care providers also need comprehensive education and training.