Strengths and limitations
To the best of our knowledge, this case control study was the first to
evaluate the association between fundal pressure and OASI immediately
after birth with TPUS. Homogeneity of obstetric applications,
documentation of fundal pressure indications and numbers were the
strength of the present study. Major limitation of this study was the
relatively small sample size. Lack of a standardized protocol for the
application of fundal pressure and multiplicity of practitioners of
fundal pressure were the another limitations. More frequent use of
mediolateral episiotomy in fundal pressure group may obscure the effect
of fundal pressure on anal sphincter.