Is maternal posturing during labor efficient in preventing persistent occiput posterior position? A randomized controlled trial - 21/12/12
, Julie Blanc, MD b, Renaud Le Dû, MD b, c, d, Jean-Paul Renner, MD f, Xavier Carcopino, MD, PhD b, c, Anderson Loundou, PhD e, Claude d'Ercole, MD b, c
Reprints: Raoul Desbriere, MD, Service de Gynécologie Obstétrique, Hôpital St Joseph, 26 Boulevard de Louvain, 13008 Marseille, FranceRésumé |
Objective |
We sought to evaluate the efficacy of maternal posturing during labor on the prevention of persistent occiput posterior (OP) position.
Study Design |
We conducted a randomized trial including 220 patients in labor with a single fetus in documented OP position. Main outcome was the proportion of anterior rotation from OP position.
Results |
The rates of anterior rotation were, respectively, 78.2% and 76.4% in the intervention group and the control group without significant difference (P = .748). Rates of instrumental and cesarean section deliveries were not significantly different between intervention and control groups (18.2% vs 19.1%, P = .89, and 19.1% vs 17.3%, P = .73, respectively). In intervention and control groups, persistent OP position rates were significantly higher among women who had cesarean section (71.4% and 89.5%, respectively) and an instrumental delivery (25% and 33.3%, respectively) than among women who achieved spontaneous vaginal birth (5.8% and 2.8%, respectively). In multivariable analysis, body mass index and parity were found to have significant and independent impact on the probability of fetal head rotation.
Conclusion |
Our study failed to demonstrate any maternal or neonatal benefit to a policy of maternal posturing for the management of OP position during labor.
Le texte complet de cet article est disponible en PDF.Key words : fetal malposition, persistent occiput posterior position, posture
Plan
| The authors report no conflict of interest. |
|
| Cite this article as: Desbriere R, Blanc J, Le Dû R, et al. Is maternal posturing during labor efficient in preventing persistent occiput posterior position? A randomized controlled trial. Am J Obstet Gynecol 2013;208:60.e1-8. |
Vol 208 - N° 1
P. 60.e1-60.e8 - janvier 2013 Retour au numéro
Article précédent
- First-trimester metabolomic detection of late-onset preeclampsia
- Ray O. Bahado-Singh, Ranjit Akolekar, Rupasri Mandal, Edison Dong, Jianguo Xia, Michael Kruger, David S. Wishart, Kypros Nicolaides
- Blunt vs sharp uterine expansion at lower segment cesarean section delivery: a systematic review with metaanalysis
- Lileane Liang Xu, Anthony Minh Tien Chau, Andrew Zuschmann
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?