Comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position
| Autor: | Wenzhi Cai, Xiao-Lan Guo, Ren-Fei Guo, Li-Hua Huang, Xiaoli Zhang, Jing Li, Xiao-Yu Zhou, Yu-Jing Lu, Hong-Yu Zhang, Rong Shu, Min Chen, Jun-Qin Wu, Ning-Ning Zhao, Yu-Hong Yang, Ying-Xia Li |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Episiotomy
medicine.medical_specialty Supine position medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Multicenter trial mental disorders medicine 030212 general & internal medicine General Nursing lcsh:RT1-120 Asphyxia Hands-and-knees delivery position 030219 obstetrics & reproductive medicine lcsh:Nursing postpartum bleeding Obstetrics business.industry medicine.disease Surgery Perineum Position (obstetrics) medicine.anatomical_structure Neonatal outcomes Supine delivery position medicine.symptom business psychological phenomena and processes |
| Zdroj: | International Journal of Nursing Sciences, Vol 3, Iss 2, Pp 178-184 (2016) |
| ISSN: | 2352-0132 |
| DOI: | 10.1016/j.ijnss.2016.05.001 |
| Popis: | Background The supine position is the most common birth position adopted in China, but the World Health Organization recommends non-supine positions for delivery. The hands-and-knees position shows several advantages, such as wide pelvic diameter and easy fetal rotation during delivery. Small trials conducted in China in 2011 revealed that the hands-and-knees position resulted in improved maternal and neonate outcomes than those in the supine position. However, a comprehensive study must be conducted before the hands-and-knees position can be introduced into clinical practice. Hence, we conducted this multicenter trial to comprehensively examine the benefits of the hands-and-knees position over the supine position during delivery. Methods Our clinical study was conducted in 11 hospitals in China from May to December 2012. A total of 446 pregnant women who gave birth in the hands-and-knees position were assigned into the experimental group, and 440 women who gave birth in the supine position were classified into the control group. Episiotomy rate was evaluated as the primary outcome, and perineum laceration degree was considered the secondary outcome. Results Women in the experimental group achieved lower rates of episiotomy and higher rates of intact perineum and first-degree perineum lacerations compared with those in the control. Postpartum bleeding amount, neonatal asphyxia, and APGAR scores at 1 and 5 min were not significantly different between the two groups. Conclusions This study proves that women who delivered in the hands-and-knees position achieved low rates of episiotomy and intact perineum. Moreover, the rates of neonatal asphyxia and postpartum bleeding did not increase. Pregnant patients who prefer to adopt the hands-and-knees position should be assisted in assuming such position during delivery. |
| Databáze: | OpenAIRE |
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