Manual Uterine Fundal Pressure in the Spontaneous Delivery during the Second Stage of Labor: A Pilot Case-Control Study Following an Analysis of Questionnaire Survey

Background: Recent obstetrical practice tends to avoid the use of manual uterine fundal pressure (MUFP);however, data showed that MUFP is actually employed. We here attempted 1) to determine the obstetricians’ attitudes towards MUFP via questionnaire, and 2) to examine whether MUFP shortens the 2nd stage of labor, with the latter tested as a pilot study. Methods: A questionnaire-based study was carried out (n = 122) at meetings of Obstetrics on May 5, 2017. Then, we conducted a pilot case-control study from August 23 to September 6, 2020. Participants (n = 29) were divided into two groups;women who did and did not want MUFP;i.e., MUFP (n = 14) vs. (Non-MUFP) group (n = 15). Results: Of 122 doctors, 99.18% (121/122) used MUFP at cesarean section. 95.90% (117/122) of institutions used MUFP in spontaneous delivery. 95.08% (116/122) obstetricians considered MUFP effective and helpful. 85.24% (104/122) considered that MUFP should be employed after station +3. In the case control study, MUFP vs. Non-MUFP group showed the second-stage-duration of 58.5 (50.25 - 71.25) vs. 48 (39 - 59) minutes, without statistical significance (P = 0.101). However, importantly, MUFP, compared with Non-MUFP group, showed a significantly shorter duration from head visible on introitus (apparition) to delivery;i.e., 21.26 ± 7.32 vs. 30.13 ± 10.61 minutes (P = 0.014). Conclusions: MUFP is still used widely and MUFP shortened the duration of head apparition to delivery time. Larger-sample studies are needed to confirm the efficacy and safety of MUFP.

Lin28B Expression in Reduced Uterine Perfusion Pressure Rat Model

Objective:Preeclampsia(PE)is a serious complication of pregnancy.Placental ischemia could be an initiating event,but the molecular mechanisms underlying PE are unclear.Lin28B,a paralog of Lin28 RNA-binding protein,is predominantly expressed in human placenta,and decreased Lin28B expression may play a role in PE by reducing trophoblast invasion.The current study was intended to verify whether Lin28B plays a role in the pathogenesis of PE in rat model for reduced uterine perfusion pressure(RUPP).Methods:We used RUPP rat model.The changes in blood pressure,24-h urine protein excretion,and fetal development in RUPP rats were recorded and compared to those of normal pregnant(NP)rats.Furthermore,the expression of Lin28B mRNA and protein in placenta was determined using quantitative real-time polymerase chain reaction,Western blotting,and immunohistochemistry.Results:The blood pressure,24-h urine protein excretion,and embryo absorption rate were significantly increased in RUPP rats on the 20^(th) day of gestational period compared with the NP rats(P<0.001).However,there was no difference in the weight of placenta in RUPP versus NP rats(P>0.05).The expression levels of Lin28B mRNA and protein in the placenta of RUPP rats were also significantly decreased in comparison to NP rats(P<0.001).Conclusion:Our results show that the expression of Lin28B in the placenta of RUPP rats is different from that in NP rats,thus suggesting a role of Lin28B in the pathogenesis of preeclampsia.