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In pregnant women without epidural analgesia, adopting the semi-prone and knee-chest positions during labor can offer benefits in terms of maternal and neonatal outcomes.
According to a randomized clinical trial, the semi-prone and knee-chest positions lead to enhanced spontaneous rotation of the occiput to the anterior position during labor, resulting in increased rates of vaginal delivery and a shorter active phase of labor. Additionally, these positions contribute to reduced low back pain after delivery. The investigators conducted a study to examine the influence of maternal labor positions on fetal occiput posterior (OP) position and pregnancy outcomes during labor.
The study involved 180 primigravida women in labor with a single fetus in the OP position. They were randomized into 3 groups: supine position (n=90), knee-chest position (n=45), and semi-prone position (n=45). Each group maintained their respective positions for 15-30 minutes until delivery. Data collection utilized a researcher-made checklist and the visual analogue scale (VAS). The analysis involved ANOVA, Tukey post hoc, and the chi-square test.
Following the intervention, among volunteers with OP position, 33.7% in the control group, 14.3% in the knee-chest position, and 16.3% in the semi-prone position remained with OP at birth (X3=7.87). Both the semi-prone and knee-chest positions showed a substantially greater rate of natural delivery. Additionally, low back pain and the active phase of labor duration dropped in the knee-chest and semi-prone positions in comparison with the control group.
No variation was found in the occurrence of perineal tears, use of oxytocin, rate of neonatal admission to intensive care unit, APGAR score, and duration of the third stage of labor among the groups. Both the semi-prone and knee-chest positions led to a higher rate of spontaneous occiput rotation to the anterior position, increased vaginal delivery rates, and a reduced duration of the active phase of labor, along with decreased low back pain post delivery.
The findings are a breakthrough in understanding how simple changes in maternal positioning during labor can positively impact childbirth outcomes. These results may help reduce maternal and neonatal complications associated with the OP position. Also, this study has the potential to revolutionize childbirth practices and provide expectant mothers with valuable information to ensure safer and more comfortable deliveries.
Journal of Family and Reproductive Health
The Impact of Maternal Position in Labor on Occiput-posterior Position of Fetus and Pregnancy Outcomes in Pregnant Women Without Epidural Analgesia
Hadis Bahmaei et al.
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