Effectiveness of maternal postural changes on the occipitoposterior position of the fetal head

María Domínguez-Mejías, Laura Falcón-Carvajal
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Abstract

Introduction: The main dystocia due to fetal position abnormalities is the occipital posterior (OP) position, which in turn is considered the most common malposition at the time of delivery. Although the incidence of deliveries in OPP is low, the complications that accompany it have led to the consideration of a series of methods that attempt to favor the rotation of the fetal head and thus improve maternal-fetal outcomes. Objective: To evaluate the effectiveness of the hands-knees and lateral decubitus positions towards the side of the fetal dorsum on the rate of rotation of the fetal head from an occipital posterior position to an occipital anterior (OA) position. Methodology: A bibliographic search has been carried out in different databases such as: Pubmed, Cochrane and Scielo. Results: Numerous studies have been carried out to find out which is the most indicated maternal position to rotate posterior fetal positions, demonstrating the effectiveness of the modified Sims position. For the quadruped position, statistically significant results have been obtained for the specific variable of persistent low back pain, notably reducing it during the first stage of labor. Conclusions: Postural changes have been found to be beneficial in favoring the rotation of the fetal head and descent through the birth canal; they are also simple and inexpensive techniques that help to favor the fit of the fetal head.
产妇体位改变对胎儿头枕后位的影响
胎儿体位异常导致的主要难产是枕后(OP)位,这被认为是分娩时最常见的体位异常。虽然OPP的分娩发生率很低,但伴随的并发症已经导致考虑一系列的方法,试图有利于胎儿头部的旋转,从而改善母胎结局。目的:评价手膝位和胎儿背侧侧卧位对胎儿头由枕后位向枕前位旋转速率的影响。方法:在Pubmed、Cochrane和Scielo等不同的数据库中进行了文献检索。结果:有大量的研究发现,哪个体位是最适合旋转胎儿后位的产妇体位,证明了改良Sims体位的有效性。对于四足体位,持续腰痛这一特定变量的结果具有统计学意义,分娩第一阶段腰痛明显减轻。结论:体位改变有利于胎头旋转和通过产道下降;它们也是简单和廉价的技术,有助于有利于胎儿头部的适合。
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