title: Selective uterine fundal pressure maneuver during the second stage of the first twin delivery at near term.
abstract: OBJECTIVE
  We examined the perinatal outcomes of twin deliveries following selective uterine fundal pressure maneuver (UFPM) during the second stage of the first twin delivery.
  
  
  METHODS
  At our institute, if non-reassuring fetal heart rate and/or maternal exhaustion were observed during the second stage of the first twin, selective UFPM was performed following making sure of the position of the first twin's buttocks by ultrasonography. We reviewed the obstetric records of all cases of trial of vaginal delivery of twins between 2002 and 2012.
  
  
  RESULTS
  A total of 64 cases were evaluated for the statistical analyses. Of these, selective UFPM for the first twin was performed in 15 cases (24%). Although the cases requiring selective UFPM for the first twin was associated with an increased postpartum hemorrhage, there were no significant differences in neonatal outcomes between the two groups.
  
  
  CONCLUSIONS
  There was no evidence that the selective UFPM is unsafe for both mother and two babies during the second stage of the first twin delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital , Tokyo , Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007748:Labor Stage, Second / Q000502:physiology*; D011247:Pregnancy; D059285:Pregnancy, Twin; D011312:Pressure; D012189:Retrospective Studies; D047929:Term Birth; D014427:Twins; D014599:Uterus / Q000502:physiology
keywords: First twin; perinatal outcome; uterine fundal pressure maneuver