Bahmaei Hadis, Mousavi Parvaneh, Haghighizadeh Mohammad Hosein, Iravani Mina
Department of Midwifery, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Reproductive Health Promotion Research Center, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
J Family Reprod Health. 2023 Jun;17(2):86-92. doi: 10.18502/jfrh.v17i2.12871.
Fetal occiput posterior (OP) position is associated with more maternal and neonatal complications. This study aimed to investigate the effect of maternal position during labor on fetal OP position and pregnancy outcomes.
This randomized clinical trial study included 180 primigravida women in labor with a single fetus and approved OP position. Participants were randomly allocated into three groups: semi-prone position (n=45), knee-chest position (n=45), and supine position (n=90). All participants were placed in the defined positions 15-30 min in labor until delivery. Data collected using Visual Analogue Scale and researcher made checklist. The ANOVA, Tukey post hoc, and the chi-square test were used to analyze.
Among all participants who had OP, after intervention 16.3% in the semi-prone position, 14/3 % in the knee-chest position, and 33.7% of the control groups remained with OP at birth (X=7/87, P=0.019). The rate of natural delivery was significantly higher in the semi-prone position and knee-chest position. The duration of active phase of labor and low back pain were significantly reduced in the semi-prone and knee-chest position compared to the control groups (P<0.05). There were no differences in the duration of the third stage of labor, APGAR score, and the rate of neonatal addition to neonatal intensive care unit, using oxytocin, and perineal tears (P>0.05).
The semi-prone and knee-chest positions increase the spontaneous rotation of occiput to the anterior position, vaginal delivery rates as well as a reduction in duration of active phase of labor and low back pain after delivery.
胎儿枕后位（OP）与更多的母体和新生儿并发症相关。本研究旨在探讨分娩期间母体体位对胎儿OP位及妊娠结局的影响。
这项随机临床试验研究纳入了180名单胎初产妇，且胎位为确诊的OP位。参与者被随机分为三组：半俯卧位（n = 45）、膝胸卧位（n = 45）和仰卧位（n = 90）。所有参与者在分娩15 - 30分钟后被置于规定体位直至分娩。使用视觉模拟量表和研究人员制作的检查表收集数据。采用方差分析、Tukey事后检验和卡方检验进行分析。
在所有胎位为OP的参与者中，干预后，半俯卧位组16.3%、膝胸卧位组14.3%以及对照组33.7%的胎儿在出生时仍为OP位（X = 7.87，P = 0.019）。半俯卧位和膝胸卧位组的自然分娩率显著更高。与对照组相比，半俯卧位和膝胸卧位组的活跃期分娩时间和腰痛明显缩短（P < 0.05）。第三产程时间、阿氏评分、新生儿入住新生儿重症监护病房的比例、使用缩宫素的情况以及会阴撕裂情况均无差异（P > 0.05）。
半俯卧位和膝胸卧位可增加枕骨向前位的自发旋转、阴道分娩率，并缩短分娩活跃期时间以及产后腰痛。
