Conclusion
Fundal pressure is commonly considered before operative vaginal birth or cesarean section in the case of a prolonged second stage of delivery or fetal distress especially in settings where instrumental deliveries, are not readily available, or cannot be performed because of professional staff shortage. It is important to objectively evaluate safety of fundal pressure on anal sphincter injury. According to our results, we concluded that fundal pressure during the second stage of delivery is not associated with a higher risk of OASI. Further well designed, large prospective studies are needed to estimate the long-term anatomical and functional outcomes of fundal pressure on anal sphincter.