Wu X, Fan L, Wang Q
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital University of Medical Sciences, Beijing 100006, China.
Zhonghua Fu Chan Ke Za Zhi. 2001 Aug;36(8):468-9.
To investigate the effect on correction of occipito-posterior (OP) by changing maternal posture during labor.
One hundred normal primigravida with head OP position in the latent phase of labor were randomly divided into 2 groups: Group A (n = 50), women were instructed to lay on the same lateral posture with the fetal spine during labor in order to correct the fetal position from OP to occipito anterior (OA); Group B (n = 50) lay on the opposite side to the fetal spine. The OP position was diagnosed by vaginal examination or B ultrasound, and the course of labor and mode of delivery were observed.
Thirty-four women delivered vaginally (68%) in group A, with 27 of them turned to OA position (54%); spontaneously while they were 22 (44%) and 12 (24%) in group B respectively, a significant difference was shown (P < 0.005). The average time interval for the 1st stage was (13.5 +/- 6.5) hour and (17.1 +/- 7.2) hour for group A and B respectively, also a significant difference was noted (P < 0.01).
To instruct women in labor to take the lateral recumbent position with the same side of fetal spine for correcting OP to OA is an effective method. It may increase vaginal deliveries and shorten the first stage of labor, thus reduce dystocia due to OP position. This method is simple and effective, and maybe adopted in most obstetric units.
探讨产程中改变产妇体位对枕后位(OP)转正的影响。
将100例产程潜伏期胎头为OP位的初产妇随机分为两组:A组(n = 50),指导产妇在产程中采取与胎儿脊柱同侧的侧卧位以纠正胎位,使OP转为枕前位(OA);B组(n = 50),采取与胎儿脊柱异侧的侧卧位。通过阴道检查或B超诊断OP位,并观察产程及分娩方式。
A组34例(68%)经阴道分娩,其中27例转为OA位(54%),均为自然转为;B组分别为22例(44%)和12例(24%),差异有统计学意义(P < 0.005)。A组和B组第一产程平均时间间隔分别为(13.5 ± 6.5)小时和(17.1 ± 7.2)小时,差异有统计学意义(P < 0.01)。
指导产程中的产妇采取与胎儿脊柱同侧的侧卧位将OP转为OA是一种有效的方法。它可增加阴道分娩率,缩短第一产程,从而减少因OP位导致的难产。该方法简单有效,多数产科单位均可采用。