Does pregnancy and/or shifting positions create more room in a woman’s pelvis?

Reitter, A.; Daviss, Betty-Anne; Bisits, Andrew; Schollenberger, Astrid; Vogl, T. J.; Herrmann, Eva; Louwen, Frank; Zangos, Stephan

doi:10.1016/j.ajog.2014.06.029

Cited by 71 publications

(87 citation statements)

References 16 publications

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“…In a cephalic presentation, an upright position is associated with a shorter second stage . Compared with the dorsal supine position, the all‐fours position considerably increases pelvic dimensions on magnetic resonance imaging . Delivery with the woman in a forward‐facing position (squatting or all fours) is the position favoured by many experienced operators claiming, particularly, that it is easier to observe for signs that the delivery will be more difficult.Evidence level 3…”

Section: What Is Appropriate Intrapartum Management Of the Term Breech?mentioning

confidence: 99%

Management of Breech Presentation

2017

BJOG

126

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Section: What Is Appropriate Intrapartum Management Of the Term Breech?mentioning

confidence: 99%

Management of Breech Presentation

2017

BJOG

126

View full text Add to dashboard Cite

“…Short-term hormonal effects of pregnancy and birthing on sacroiliac and pubic joint motility, as well as the effects of body position on pelvic obstetric dimensions, are well documented (48)(49)(50). However, the age-matched sample of parous and nonparous individuals studied here does not provide evidence for major effects of pregnancy and lactation on the development of female-specific pelvic morphology.…”

Section: Discussionmentioning

confidence: 70%

Developmental evidence for obstetric adaptation of the human female pelvis

Huseynov

Zollikofer

Coudyzer

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

163

143

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The bony pelvis of adult humans exhibits marked sexual dimorphism, which is traditionally interpreted in the framework of the "obstetrical dilemma" hypothesis: Giving birth to large-brained/ large-bodied babies requires a wide pelvis, whereas efficient bipedal locomotion requires a narrow pelvis. This hypothesis has been challenged recently on biomechanical, metabolic, and biocultural grounds, so that it remains unclear which factors are responsible for sex-specific differences in adult pelvic morphology. Here we address this issue from a developmental perspective. We use methods of biomedical imaging and geometric morphometrics to analyze changes in pelvic morphology from late fetal stages to adulthood in a knownage/known-sex forensic/clinical sample. Results show that, until puberty, female and male pelves exhibit only moderate sexual dimorphism and follow largely similar developmental trajectories. With the onset of puberty, however, the female trajectory diverges substantially from the common course, resulting in rapid expansion of obstetrically relevant pelvic dimensions up to the age of 25-30 y. From 40 y onward females resume a mode of pelvic development similar to males, resulting in significant reduction of obstetric dimensions. This complex developmental trajectory is likely linked to the pubertal rise and premenopausal fall of estradiol levels and results in the obstetrically most adequate pelvic morphology during the time of maximum female fertility. The evidence that hormones mediate female pelvic development and morphology supports the view that solutions of the obstetrical dilemma depend not only on selection and adaptation but also on developmental plasticity as a response to ecological/nutritional factors during a female's lifetime.pelvis | development | evolution | obstetrical dilemma | sex steroids

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“…Durante las últimas décadas, el parto en posición vertical se ha venido investigando y se ha creado controversia respecto a su práctica y sus benecios [12]. Se cree que esta posición posee ventajas respecto al parto en posición horizontal, relacionadas con los efectos de la gravedad, aumento de la dimensión transversal y anteroposterior del plano pélvico, disminución del tiempo expulsivo, contracciones uterinas más ecaces, mayor participación de la madre, eciencia en el pujo y menos casos de frecuencia cardiaca fetal anormal [12,13,14,15], lo cual benecia tanto a la madre como a su hijo. Estas ventajas contribuyen a disminuir las complicaciones del parto, por tanto, a la mortalidad materna y perinatal.…”

Section: Introductionunclassified

Ventajas y desventajas del parto vertical en contraste con el parto horizontal: una revisión de la literatura

Londoño

Castiblanco

Acosta

et al. 2018

Investg. Enferm. Imagen Desarollo.

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El parto vertical es una práctica ancestral que puede ofrecer ventajas para la madre y su recién nacido. Objetivo: integrar los hallazgos que informa la literatura sobre ventajas y desventajas del parto vertical en contraste con el parto horizontal. Método: revisión integrativa de la literatura publicada en el periodo 2005-2015. Se seleccionaron quince estudios, luego de un proceso de búsqueda y crítica de literatura. Los datos se extrajeron, analizaron y compararon con apoyo en la herramienta ATLAS.ti, versión 7.0. Resultados: esta revisión integró los hallazgos de los artículos seleccionados, de los cuales emergieron doce subtemas que se clasificaron en los dos temas planteados: ventajas y desventajas del parto vertical en contraste al parto horizontal. Se encontraron las siguientes ventajas: disminución en el tiempo en la segunda etapa, menos desgarros de tercer y cuarto grado, menor edema vulvar, menor necesidad de instrumentación, menor necesidad de episiotomía, menos casos de presión del fondo uterino, menos casos de placenta retenida, menor dolor, mejor percepción de la materna y mejores resultados fetales y neonatales. Como desventajas se encontraron: mayor sangrado y dicultad de mantener la posición. Conclusión: esta revisión encontró que el parto en posición vertical tiene más ventajas en contraste a la posición horizontal, lo que beneficia fisiopsicológicamente tanto a la madre como alneonato.

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Does pregnancy and/or shifting positions create more room in a woman’s pelvis?

Cited by 71 publications

References 16 publications

Management of Breech Presentation

Management of Breech Presentation

Developmental evidence for obstetric adaptation of the human female pelvis

Ventajas y desventajas del parto vertical en contraste con el parto horizontal: una revisión de la literatura

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