Moraloglu Ozlem, Kansu-Celik Hatice, Tasci Yasemin, Karakaya Burcu Kısa, Yilmaz Yasar, Cakir Ebru, Yakut Halil Ibrahim
a Perinatology Unit, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey and.
b Neonatology Unit, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey.
J Matern Fetal Neonatal Med. 2017 Jan;30(2):245-249. doi: 10.3109/14767058.2016.1169525. Epub 2016 Apr 19.
To assess the effects on neonatal and maternal outcomes of different pushing positions during the second stage of labor in nulliparous women.
This prospective study included 102 healthy, pregnant, nulliparous women who were randomly allocated to either of two positions: a squatting using bars (n = 51), or a supine position modified to 45 degree of semi-fowler (n = 51) during the second stage of labor. Duration of the second stage of labor, maternal pain, postpartum blood loss, abnormal fetal heart rate patterns that required intervention, and newborn outcomes were compared between the two groups.
The trial showed that women who adopted the squatting position using bars experienced a significant reduction in the duration of the second stage of labor; they were less likely to be induced, and their Visual Analog Scale score was lower than those who were allocated the supine position modified to 45 degree of semi-fowler during second stage of labor (p < 0.05). There were no significant differences with regard to postpartum blood loss, neonatal birth weight, Apgar score at one and five minutes, or admission to the Neonatal Intensive Care Unit.
In healthy nulliparous women, adopting a squatting position using bars was associated with a shorter second stage of labor, lower Visual Analog Scale score, more satisfaction, and a reduction in oxytocin requirements compared with adopting the supine position. For Turkish women, the squatting position is easy to adopt as it is more appropriate in terms of Turkish social habits and traditions.
评估初产妇第二产程不同用力姿势对母婴结局的影响。
这项前瞻性研究纳入了102名健康的、怀孕的初产妇，她们在第二产程中被随机分配到两个姿势组中的一组：使用横杆蹲姿（n = 51），或改为45度半卧位的仰卧姿势（n = 51）。比较两组的第二产程时长、产妇疼痛程度、产后失血量、需要干预的异常胎心模式以及新生儿结局。
试验表明，采用横杆蹲姿的女性第二产程时长显著缩短；她们引产的可能性较小，视觉模拟评分低于第二产程中被分配到改为45度半卧位仰卧姿势的女性（p < 0.05）。在产后失血量、新生儿出生体重、1分钟和5分钟阿氏评分或入住新生儿重症监护病房方面，两组之间没有显著差异。
与仰卧姿势相比，健康初产妇采用横杆蹲姿与第二产程缩短、视觉模拟评分降低、满意度更高以及催产素需求减少有关。对于土耳其女性来说，蹲姿易于采用，因为它在土耳其社会习惯和传统方面更合适。
