J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website http://www.jcgo.org

Original Article

Volume 2, Number 1, June 2013, pages 10-14

Clinical Significance of Deliveries With Uterine Fundal Pressure Maneuver at a Single Perinatal Center in Japan

**Table 1.** Analysis of Dichotomous Variables of Characteristics and Perinatal Outcomes by Uterine Fundal Pressure Maneuver in Cases Singleton Vertex Delivery
Uterine fundal pressure	(-)	(+)	P-value	Crude odds ratio	95% confidence interval
Number	5,683	634
Maternal age ≥ 35 years	1,840 (32.4)	233 (36.8)	0.026	1.21	1.0 - 1.4
Nulliparity	2,740 (48.2)	524 (82.6)	< 0.001	5.12	4.1 - 6.3
Gestational age at delivery
≤ 36 weeks	317 (5.6)	35 (5.5)	0.68	1.08	0.75 - 1.6
37 - 40 weeks	4,698 (82.7)	481 (75.9)	Ref.	1
≥ 41 weeks	668 (11.8)	118 (18.6)	< 0.001	1.73	1.4 - 2.1
Pregnancy induced hypertension	265 (4.7)	48 (7.6)	0.0013	1.67	1.2 - 2.3
Gestational diabetes mellitus	106 (1.9)	16 (2.5)	0.25	1.36	0.80 - 2.3
Oligohydramnios	371 (6.5)	64 (10.1)	< 0.001	1.61	1.2 - 2.1
Non-reassuring fetal status	353 (6.3)	214 (33.8)	< 0.001	7.58	6.2 - 9.2
Oxytocin use	1,008 (17.7)	289 (14.0)	< 0.001	3.89	3.3 - 4.6
Delivery modes
Normal delivery	5,389 (94.8)	287 (45.3)	Ref.	1
Vacuum extraction	287 (5.1)	339 (53.4)	< 0.001	22.2	18 - 27
Foeceps delivery	1 (0.0)	0 (0)	0.82	0
Cesarean section	6 (0.1)	8 (1.3)	< 0.001	25.0	8.6 - 73
Shoulder dystocia	2 (0.0)	0 (0)	0.64	0
Neonatal birth weight
< 2,500 g	574 (10.1)	55 (8.7)	0.31	0.86	0.64 - 1.2
2,500 - 3,499 g	4,546 (80.0)	506 (79.8)	Ref.	1
≥ 3,500 g	563 (9.9)	73 (11.5)	0.25	1.16	0.90 - 1.5
Apgar score < 7
at 1 minute	59 (1.0)	20 (3.2)	< 0.001	3.10	1.9 - 5.2
at 5 minute	5 (0.1)	1 (0.2)	0.59	1.79	0.21 - 15
Umbilical artery pH
< 7.0	13 (0.2)	4 (0.6)	0.064	2.77	0.90 - 8.5
< 7.1	86 (1.5)	27 (4.3)	< 0.001	2.88	1.9 - 4.5
Neonatal intensive care units admission	231 (4.1)	41 (6.5)	0.0053	1.62	1.2 - 2.3
Postpartum hemorrhage ≥ 1,000 mL	345 (6.1)	81 (12.8)	< 0.001	2.27	1.8 - 2.9
Episiotomy
None	4,057 (71.4)	59 (9.3)	Ref.	1
Mid-lateral episiotomy	1,370 (24.1)	553 (87.2)	< 0.001	27.7	21 - 37
Midline episiotomy	256 (4.5)	22 (3.5)	< 0.001	5.91	3.6 - 9.8
Perineal laceration
Non - second degree	5,587 (98.3)	591 (93.2)	Ref.	1
Third degree	82 (1.4)	34 (5.4)	< 0.001	3.91	2.6 - 5.9
Forth degree	14 (0.2)	9 (1.4)	< 0.001	6.08	2.6 - 5.9
Cervical laceration	75 (1.3)	33 (5.2)	< 0.001	4.11	2.7 - 14

Table 1. Analysis of Dichotomous Variables of Characteristics and Perinatal Outcomes by Uterine Fundal Pressure Maneuver in Cases Singleton Vertex Delivery

Uterine fundal pressure

(-)

(+)

P-value

Crude odds ratio

95% confidence interval

Number

5,683

634

Maternal age ≥ 35 years

1,840 (32.4)

233 (36.8)

0.026

1.21

1.0 - 1.4

Nulliparity

2,740 (48.2)

524 (82.6)

< 0.001

5.12

4.1 - 6.3

Gestational age at delivery

≤ 36 weeks

317 (5.6)

35 (5.5)

0.68

1.08

0.75 - 1.6

37 - 40 weeks

4,698 (82.7)

481 (75.9)

Ref.

≥ 41 weeks

668 (11.8)

118 (18.6)

< 0.001

1.73

1.4 - 2.1

Pregnancy induced hypertension

265 (4.7)

48 (7.6)

0.0013

1.67

1.2 - 2.3

Gestational diabetes mellitus

106 (1.9)

16 (2.5)

0.25

1.36

0.80 - 2.3

Oligohydramnios

371 (6.5)

64 (10.1)

< 0.001

1.61

1.2 - 2.1

Non-reassuring fetal status

353 (6.3)

214 (33.8)

< 0.001

7.58

6.2 - 9.2

Oxytocin use

1,008 (17.7)

289 (14.0)

< 0.001

3.89

3.3 - 4.6

Delivery modes

Normal delivery

5,389 (94.8)

287 (45.3)

Ref.

Vacuum extraction

287 (5.1)

339 (53.4)

< 0.001

22.2

18 - 27

Foeceps delivery

1 (0.0)

0 (0)

0.82

Cesarean section

6 (0.1)

8 (1.3)

< 0.001

25.0

8.6 - 73

Shoulder dystocia

2 (0.0)

0 (0)

0.64

Neonatal birth weight

< 2,500 g

574 (10.1)

55 (8.7)

0.31

0.86

0.64 - 1.2

2,500 - 3,499 g

4,546 (80.0)

506 (79.8)

Ref.

≥ 3,500 g

563 (9.9)

73 (11.5)

0.25

1.16

0.90 - 1.5

Apgar score < 7

at 1 minute

59 (1.0)

20 (3.2)

< 0.001

3.10

1.9 - 5.2

at 5 minute

5 (0.1)

1 (0.2)

0.59

1.79

0.21 - 15

Umbilical artery pH

< 7.0

13 (0.2)

4 (0.6)

0.064

2.77

0.90 - 8.5

< 7.1

86 (1.5)

27 (4.3)

< 0.001

2.88

1.9 - 4.5

Neonatal intensive care units admission

231 (4.1)

41 (6.5)

0.0053

1.62

1.2 - 2.3

Postpartum hemorrhage ≥ 1,000 mL

345 (6.1)

81 (12.8)

< 0.001

2.27

1.8 - 2.9

Episiotomy

None

4,057 (71.4)

59 (9.3)

Ref.

Mid-lateral episiotomy

1,370 (24.1)

553 (87.2)

< 0.001

27.7

21 - 37

Midline episiotomy

256 (4.5)

22 (3.5)

< 0.001

5.91

3.6 - 9.8

Perineal laceration

Non - second degree

5,587 (98.3)

591 (93.2)

Ref.

Third degree

82 (1.4)

34 (5.4)

< 0.001

3.91

2.6 - 5.9

Forth degree

14 (0.2)

9 (1.4)

< 0.001

6.08

2.6 - 5.9

Cervical laceration

75 (1.3)

33 (5.2)

< 0.001

4.11

2.7 - 14

**Table 2.** Adjusted Odds Ratios and 95% Confidence Intervals Associated With Uterine Fundal Pressure Maneuver Using Logistic Multivariable Regression Analysis
	P-value	Adjusted odds ratio	95% confidence interval
Maternal age ≥ 35 years	0.12	1.15	0.96 - 1.4
Nulliparity	< 0.001	2.55	2.0 - 3.2
Gestational age at delivery ≥ 41 weeks	0.13	1.19	0.95 - 1.5
Pregnancy induced hypertension	0.081	1.36	0.96 - 1.9
Oligohydramnios	0.023	1.41	1.1 - 1.9
Non-reassuring fetal status	< 0.001	4.12	3.3 - 5.2
Oxytocin use	< 0.001	1.47	1.2 - 1.8
Delivery modes
Vacuum extraction	< 0.001	10.4	8.3 - 13
Cesarean section	0.021	4.44	1.1 - 18
Apgar score < 7 at 1 minute	0.23	1.51	0.77 - 3.0
Umbilical artery pH < 7.1	0.19	1.56	0.80 - 3.1
Neonatal intensive care units admission	0.13	1.33	0.92 - 1.91
Postpartum hemorrhage ≥ 1,000 mL	0.018	1.45	1.1 - 2.0
Episiotomy
Mid-lateral episiotomy	< 0.001	7.88	6.2 - 10
Midline episiotomy	0.16	1.60	0.82 - 3.1
Perineal laceration
Third degree	0.0042	2.10	1.3 - 3.5
Forth degree	0.073	2.66	0.87 - 8.1
Cervical laceration	0.022	1.86	1.1 - 3.2

Table 2. Adjusted Odds Ratios and 95% Confidence Intervals Associated With Uterine Fundal Pressure Maneuver Using Logistic Multivariable Regression Analysis

P-value

Adjusted odds ratio

95% confidence interval

Maternal age ≥ 35 years

0.12

1.15

0.96 - 1.4

Nulliparity

< 0.001

2.55

2.0 - 3.2

Gestational age at delivery ≥ 41 weeks

0.13

1.19

0.95 - 1.5

Pregnancy induced hypertension

0.081

1.36

0.96 - 1.9

Oligohydramnios

0.023

1.41

1.1 - 1.9

Non-reassuring fetal status

< 0.001

4.12

3.3 - 5.2

Oxytocin use

< 0.001

1.47

1.2 - 1.8

Delivery modes

Vacuum extraction

< 0.001

10.4

8.3 - 13

Cesarean section

0.021

4.44

1.1 - 18

Apgar score < 7 at 1 minute

0.23

1.51

0.77 - 3.0

Umbilical artery pH < 7.1

0.19

1.56

0.80 - 3.1

Neonatal intensive care units admission

0.13

1.33

0.92 - 1.91

Postpartum hemorrhage ≥ 1,000 mL

0.018

1.45

1.1 - 2.0

Episiotomy

Mid-lateral episiotomy

< 0.001

7.88

6.2 - 10

Midline episiotomy

0.16

1.60

0.82 - 3.1

Perineal laceration

Third degree

0.0042

2.10

1.3 - 3.5

Forth degree

0.073

2.66

0.87 - 8.1

Cervical laceration

0.022

1.86

1.1 - 3.2