Position in the second stage of labour for women with epidural anaesthesia

Kibuka, Marion; Thornton, Jim; Kingswood, Claire J

doi:10.1002/14651858.cd008070

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…Supine maternal delivery position in our collective was associated with a higher bladder function domain score, bowel function domain score, sexual function domain score and total questionnaire score. The literature is inconsistent with regard to supine delivery position and subsequent risks, but a Cochrane analysis from 2017 found no association between delivery position, perineal injury and subsequent pelvic floor function [16]. Similar to the results published in two other studies, vacuum delivery in our study was associated with negative effects on bowel function [3,7].…”

Section: Risk Factors For Pelvic Floor Insufficiencysupporting

confidence: 84%

Fishing for (in)continence: long-term follow-up of women with OASIS–still a taboo

Schütze

Hohlfeld

Friedl

et al. 2020

Arch Gynecol Obstet

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Purpose Obstetric anal sphincter injuries (OASIS) increase the risk for pelvic floor dysfunctions. The goal of this study was to examine the long-term outcomes after OASIS on pelvic floor functions and quality of life. Material and methods Between 2005 and 2013, 424 women had an OASIS at the Women University Hospital Ulm. Out of these 71 women completed the German pelvic floor questionnaire, which includes questions regarding prolapse symptoms as well as bladder, bowel and sexual function. In addition, 64 women were physically examined, including a speculum examination to evaluate the degree of prolapse, a cough test to evaluate urinary stress incontinence (SI) and an evaluation of both pelvic floor sphincter (modified Oxford score) and anal sphincter contraction. Results A high rate of pelvic floor disorders after OASIS was found, as 74.6% of women reported SI, 64.8% flatus incontinence and 18.3% stool incontinence, respectively. However, only few women stated a substantial negative impact on quality of life. The clinical examination showed that a positive cough test, a weak anal sphincter tone and a diagnosed prolapse correlated with the results of the self-reported questionnaire. Conclusion On one hand, OASIS has an influence on pelvic floor function going along with lots of complaints, while on the other hand, it still seems to be a taboo topic, as none of the participants spoke about the complaints after OASIS with a doctor. Therefore, the gynecologist should actively address these issues and offer therapy options for the women with persisting problems.

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Section: Risk Factors For Pelvic Floor Insufficiencysupporting

confidence: 84%

Fishing for (in)continence: long-term follow-up of women with OASIS–still a taboo

Schütze

Hohlfeld

Friedl

et al. 2020

Arch Gynecol Obstet

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“… 48 Concerns about safety have been raised with the use of CM interventions and upright positions in labour, including the risk of postpartum haemorrhage (PPH), 49 or neonatal complications. 50 However, the review did not find evidence to support these concerns. 48 …”

Section: Introduction and Rationalementioning

confidence: 96%

The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis

et al. 2020

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IntroductionRates of medical interventions in normal labour and birth are increasing. This prospective meta-analysis (PMA) proposes to assess whether the addition of a comprehensive multicomponent birth preparation programme reduces caesarean section (CS) in nulliparous women compared with standard hospital care. Additionally, do participant characteristics, intervention components or hospital characteristics modify the effectiveness of the programme?Methods and analysisPopulation: women with singleton vertex pregnancies, no planned caesarean section (CS) or epidural.Intervention: in addition to hospital-based standard care, a comprehensive antenatal education programme that includes multiple components for birth preparation, addressing the three objectives: preparing women and their birth partner/support person for childbirth through education on physiological/hormonal birth (knowledge and understanding); building women’s confidence through psychological preparation (positive mindset) and support their ability to birth without pain relief using evidence-based tools (tools and techniques). The intervention could occur in a hospital-based or community setting.Comparator: standard care alone in hospital-based maternity units.OutcomesPrimary: CS.Secondary: epidural analgesia, mode of birth, perineal trauma, postpartum haemorrhage, newborn resuscitation, psychosocial well-being.Subgroup analysis: parity, model of care, maternal risk status, maternal education, maternal socio-economic status, intervention components.Study designAn individual participant data (IPD) prospective meta-analysis (PMA) of randomised controlled trials, including cluster design. Each trial is conducted independently but share core protocol elements to contribute data to the PMA. Participating trials are deemed eligible for the PMA if their results are not yet known outside their Data Monitoring Committees.Ethics and disseminationParticipants in the individual trials will consent to participation, with respective trials receiving ethical approval by their local Human Research Ethics Committees. Individual datasets remain the property of trialists, and can be published prior to the publication of final PMA results. The overall data for meta-analysis will be held, analysed and published by the collaborative group, led by the Cochrane PMA group.Trial registration numberCRD42020103857.

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“…In summary, the purpose of implementation of an upright position is for the enhancement of uterine contractions, fetal condition, and the promotion of maternal comfort (5)(6)(7). Flexible sacrum positions (FSP=knee-standing, on all fours, sitting on a birth seat and lateral) is where weight is taken off the sacrum, thereby allowing the pelvic outlet to expand well (8,9).…”

Section: Introductionmentioning

confidence: 99%

Effect of maternal birth positions on duration of second stage of labor: Systematic review and meta-analysis

Badi

Lindgren

Christensson

et al. 2019

Preprint

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Background: it is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the uterus to contract more strongly and efficiently, the baby gets in a better position and thus can pass through the pelvis faster. Upright and lateral positions enables flexibility in the pelvis and facilitates the extension of the outlet. Before implementing a change in birthing positions in our clinics we need to review evidences available and context valid related to duration of second stage of labor and birthing positions. Objective: The aim of this review was to examine the effect of maternal flexible sacrum birth position on duration of second stage of labor. Method: The research searched articles using bibliographical Databases: Medline/PUBMED, SCOPUS, Google scholar and Google. All study designs were considered while investigating the impact of maternal flexible sacrum birthing positioning in relation duration of second stage of labor. Studies including laboring mothers with normal labor and delivery. A total of 1,985 women were included in the reviewed studies. We included both qualitative and quantitative analysis. Results: We identified 1,680 potential citations, of which 8 articles assessed the effect of maternal upright birth positioning on the reduction during the duration of second stage of labor. Two studies were excluded because of incomplete reports for meta analysis. The result suggested a reduction in duration of second stage of labor among women in a flexible sacrum birthing position, with a mean duration from 3.2-34.8. The pooled weighted mean difference with random effect model was 21.118(CI: 11.839-30.396) minutes, with the same significant heterogeneity between the studies (I 2 =96.8%, p<000). Conclusion: The second stage duration was reduced in cases of a flexible sacrum birthing position. Even though the reduction in duration varies across studies with considerable heterogeneity, laboring women should be encouraged to choose her comfortable birth position. Researchers who aim to compare different birthing positions should consider study designs which enable women to choose birthing position. Prospero registration number [CRD42019120618] Keywords: maternal position, flexible sacrum position, second stage duration

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Position in the second stage of labour for women with epidural anaesthesia

Cited by 11 publications

References 14 publications

Fishing for (in)continence: long-term follow-up of women with OASIS–still a taboo

Fishing for (in)continence: long-term follow-up of women with OASIS–still a taboo

The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis

Effect of maternal birth positions on duration of second stage of labor: Systematic review and meta-analysis

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