Calvo AO, Flores RAL, Morales GVE

Language: Spanish
References: 8
Page: 1-10
PDF size: 306.45 Kb.

ABSTRACT

Background: Vertical position is an option to delivery to which several advantages have been attributed. This research exposes its related findings.
Objective: To compare obstetric and perinatal outcomes between supine and vertical position at delivery.
Patients and method: We performed a randomized double-blind study including healthy women assigned to the supine or upright posture (vertical) during labor with complications following the delivery in the puerperium stage. The variables evaluated were: blood loss, pain in the second period of labor and immediate postpartum,duration of the second period of labor, perineal and vaginal tears, need to forceps implement, accommodation in position and perinatal outcome.
Results: 164 patients were randomized into two groups, the vertical position (I) and the supine position (II). The losses were 5.4%, and the Caesarean rate was of 4.6%. Difference was found only for vaginal tears in the vertical posture, with a relative risk of 1.4 (CI 1.1-3.2), and shortening of the second period with a significant difference of 10 minutes on average (p ‹ 0.05).
Conclusions: The upright posture during childbirth provides no improvement in perinatal outcomes and fewer obstetric conditions. It shortens the second period of labor, but it is a risk factor for vaginal tears. The best position for birth is which offers more comfort to the patient.

REFERENCES

1. Appropiate technology for birth. WHO. Lancet 1985;2:436-437.

2. Soto C, Teuber H, Cabrera C, Marín M y col. Educación prenatal y su relación con el tipo de parto: una vía hacia el parto natural. Rev Chil Obstet Ginecol 2006;71(2):98-103.

3. Gupta JK, Hofmeyr GJ. Posición de la mujer durante el periodo expulsivo del trabajo de parto (Revisión Cochrane traducida). En: La Biblioteca Cochrane Plus, 2008, núm 2. Oxford: Update Software Ltd. Disponible en: http://www.update-software.com (Traducida de The Cochrane Library, 2008 Issue 2. Chichester, UK: John Wiley & Sons, Ltd.).

4. Dunn PM. Francois Mauriceau (1637-1709) and maternal posture for parturition. Arch Dis Child 1991;66(1 spec no):78-79.

5. Méndez-González RM, Cervera-Montejano MD. Atención hospitalaria y tradicional del parto. Salud Pública Méx 2002;44(2):129-143.

6. La atención intercultural a las mujeres: el trabajo de parto en posición vertical en los servicios de salud. Dirección de Medicina Tradicional y Desarrollo Intercultural. México: Secretaría de Salud; 2009.

7. Gupta JK, Hofmeyr GJ, Smyth RMD. Position in the second stage of labour for women without epidural anaesthesia (review). The Cochrane Library 2009, issue 4, 1-72.

8. Molina-Reyes C, Huete-Morales MD, Sánchez Pérez JC, Ortiz- Albarín MD y col. Implantación de una política de episiotomía selectiva en el Hospital de Baza. Resultados materno-fetales. Prog Obstet Ginecol 2011;54(3):101-108.