Melchionda Marta Mazzeo, Aloi Tamara, Bruno Francesca, Lazzari Alessia De, Mauri Paola A, Esposito Giovanna
Midwifery School, Department of Clinical Sciences and Community Health, Dipartimento di Eccellenza 2023-2027, University of Milan, Milan, Italy.
Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Eur J Midwifery. 2025 Sep 5;9. doi: 10.18332/ejm/206972. eCollection 2025.
Optimal fetal positioning is essential for ensuring that labor progresses efficiently and reducing the need for interventions. The aim of this study was to evaluate the potential role of the Spinning Babies approach to facilitate fetal head rotation.
This retrospective study was based on data collected by midwifery students, supervised by experienced midwifery tutors, using digital partograms. The fetal position was recorded at several stages of labor, particularly at the labor onset and at the delivery. For the current analysis, only women with an occiput-posterior or occiput-transverse fetal position were included. The Spinning Babies approach was compared with a control group. The association between anterior head rotation and the use of the Spinning Babies techniques was evaluated using a log-binomial model.
A total of 244 partograms were identified. Of these, 60 women underwent the Spinning Babies approach, while the remaining 184 did not (control group). At first, in the Spinning Babies group, 40.0% were left occiput-posterior, 43.3% were right occiput-posterior, and 16.7% were occiput-transverse. In the control group the corresponding proportions were: 33.2%, 56.0%, and 10.9%. At the delivery, the fetal head rotated from posterior (or transverse) to anterior in 93.3% of women who underwent Spinning Babies techniques, compared to 63.6% of controls. The use of Spinning Babies techniques was associated with a 45% increased likelihood of achieving anterior position (RR=1.45; 95% CI: 1.23-1.72).
Optimal fetal positioning may be facilitated using Spinning Babies approach. To confirm these findings, further research using more standardized protocols and objective measures is needed.
最佳胎儿体位对于确保产程顺利进展和减少干预需求至关重要。本研究的目的是评估“胎位旋转法”在促进胎儿头部旋转方面的潜在作用。
本回顾性研究基于助产专业学生在经验丰富的助产导师指导下使用电子产程图收集的数据。在分娩的几个阶段记录胎儿体位，特别是在分娩开始时和分娩时。对于当前分析，仅纳入枕后位或枕横位的女性。将“胎位旋转法”与对照组进行比较。使用对数二项模型评估头部向前旋转与使用“胎位旋转法”技术之间的关联。
共识别出244份产程图。其中，60名女性采用了“胎位旋转法”，其余184名未采用（对照组）。起初，在“胎位旋转法”组中，40.0%为左枕后位，43.3%为右枕后位，16.7%为枕横位。对照组的相应比例分别为：33.2%、56.0%和10.9%。在分娩时，采用“胎位旋转法”技术的女性中，93.3%的胎儿头部从后位（或横位）旋转至前位，而对照组为63.6%。使用“胎位旋转法”技术使胎儿达到前位的可能性增加了45%（相对危险度=1.45；95%可信区间：1.23 - 1.72）。
使用“胎位旋转法”可能有助于实现最佳胎儿体位。为证实这些发现，需要使用更标准化的方案和客观测量方法进行进一步研究。
