Undergraduate Honors Thesis

 

Maternal Positioning in the Second Stage of Labor and Incidence of Spontaneous Perineal Trauma: A Systematic Review with Meta-Analysis of Randomized Controlled Trials Public Deposited

https://scholar.colorado.edu/concern/undergraduate_honors_theses/41687h91p
Abstract
  • Spontaneous, natural perineal trauma is a common complication faced by women following vaginal delivery. Most women in Western countries deliver in the supine position, which is typically accompanied by non-ambulatory movement restriction. The current literature suggests this position provides little physiological benefit to the mother. Therefore, this systematic review aimed to investigate, 1) restrictive, non-ambulatory Western birth practices in terms of perineal integrity, 2) freedom of movement birth practices in terms of perineal integrity. Seven randomized controlled trials were evaluated. Each study compared a non-supine position, either the squatting or sitting position, to the supine position and reported the incidence of various degrees of spontaneous perineal tears. A meta-analysis was performed and the relative risk was calculated for each study. A random-effects summary estimate was calculated and the overall relative risk was reported as 4.4108 with a 95% confidence interval of 3.1514-6.1736 and a p-value of <0.0001 (alpha level of <0.05). Results suggest that the supine position is associated with reduced spontaneous perineal trauma. Future research is needed to determine the physiological benefits of restrictive, non-ambulatory and freedom of movement birth practices on a wide variety of maternal outcomes.
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  • 2016-01-01
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  • 2019-12-02
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