Effects of maternal posture and cognitive-behavioral interventions on labor outcomes in primigravidas with abnormal fetal head position: a randomized controlled clinical trial.
Xiaofeng Wan, Jinguo Zhai, Xiaoqin Lu, Xiuhong Wang, Hamza Saidi Lilenga, Mei Luo, Xiaochun Wang, Xueyan Wang, Yanli Zhou
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引用次数: 0
Abstract
Objective: Fetal head malposition can result in neonatal and maternal complications. Fetal head malposition occurs frequently in labor. Appropriate and timely managements are required. Maternal posture and cognitive-behavioral interventions could improve labor outcomes in primigravidas with fetal head malposition.
Methods: A randomized controlled clinical trial was performed between January and December 2022 (Chinese Clinical Trial Registry, ChiCTR2100049359). Eligible primigravidas were randomly assigned into four groups. Group A received traditional perinatal care. Group B, C, and D received posture management, posture management with music therapy, and posture management with video education, respectively, in addition to traditional perinatal care. The maternal postures referred to place pregnant women in certain positions (lateral, lateral-prone, hands and knees, open knee-chest) to change the anatomical structure of pelvis, thus, to facilitate the fetal downward movement and birth. Maternal and neonatal outcomes were recorded and compared.
Results: A total of 136 primigravidas were included, with 34, 35, 34, and 33 women in group A, B, C, and D, respectively. The incidences of cesarean section were lower in groups B, C, and D than that in group A (5.7%, 2.9%, and 3.0% versus 20.6%, p < 0.05). The fetal position correction rates at the time of full dilation of cervix were higher in groups B, C, and D than that in group A (66.7%, 63.6%, 68.8% versus 27.6%, p < 0.05). Primigravidas in groups B, C, and D had better experiences and a lower anxiety level than those in group A (p < 0.001). The four groups had no statistically significant differences in the total labor duration, operative vaginal delivery, umbilical artery blood pH, and neonatal Apgar scores.
Conclusion: Fetal head malposition could happen in primigravidas. Maternal posture management and cognitive-behavioral interventions during labor could improve labor outcomes in primigravidas with fetal head malposition.
期刊介绍:
The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.