Fundal pressure: risk factors in uterine rupture. The issue of liability: complication or malpractice?

To the kind attention of the editor Sir, Following the article by Sturzenegger et al. titled “Risk factorsof uterine rupturewitha specialinteresttouterine fundal pressure” [1], we would like to contribute an obstetrical and legal perspective on fundal pressure (FP) with regard to ourrecently published review “Kristeller maneuversorfundalpressureandmaternal/neonatalmorbidity: obstetric and judicial literature review”. Literature reports many articles dealing with FP, which point to a scarred uterus as the foremost risk factor of uterine rupture(UR). Although several risk factors are described as being associated with FP in determining UR, currently there is no uniformly defined set of guidelines regulating it despite its routine use in obstetrical practice.