Effect of Free Position on Delivery and Applications on Vaginal Birth after Cesarean

doi:10.12280/gjfckx.20210844

Abstract

Abstract:

Different posture of pregnancy women during delivery has an impact on maternal-fetal outcomes. Free posture delivery is a free choice of postpartum delivery according to the mother′s own will, which benefits for both mothers and newborns. At present, with the opening of the two-child and three-child policy in our country, there are more and more pregnant women after cesarean section. Since the maternal and fetal outcome of vaginal delivery is significantly better than that of elective repeat cesarean section, more and more pregnant women choose vaginal birth after cesarean (VBAC). The application of free posture delivery in VBAC parturients has also accumulated certain experience. Free posture delivery not only helps relieve maternal tension, but also prevents and reduces dystocia by changing postural positions during labor. For women with VBAC who progress too quickly in labor should avoid vertical delivery to reduce the occurrence of emergency labor. During the second stage of labor, squat or sitting position should be avoided to prevent the occurrence of severe perineal laceration.

Key words: Vaginal birth after cesarean, Parturition, Posture, Perineum, Dystocia, Labor,obstetric

LIU Guang-pu, ZHAO Ling, ZHANG Xiao-li, ZHANG Hui-xin. Effect of Free Position on Delivery and Applications on Vaginal Birth after Cesarean[J]. Journal of International Obstetrics and Gynecology, 2022, 49(2): 133-136.

References 34

[1]	World Health Organization (WHO). Maternal and Newborn Health/Safe Motherhood Unit of the World Health Organization[S]. Care in Normal Birth: A practical guide, 1996.
[2]	中华医学会妇产科学分会产科学组. 剖宫产术后再次妊娠阴道分娩管理的专家共识(2016)[J]. 中华妇产科杂志, 2016, 51(8):561-564. doi: 10.3760/cma.j.issn.0529-567x.2016.08.001. doi: 10.3760/cma.j.issn.0529-567x.2016.08.001
[3]	周倩云, 李巧秀, 杨晓宇. 自由体位对分娩的影响研究进展[J]. 中国临床护理, 2020, 12(1):81-83. doi: 10.3969/j.issn.1674-3768.2020.01.025. doi: 10.3969/j.issn.1674-3768.2020.01.025
[4]	贺晶, 陈璐. 分娩时体位选择[J]. 中国实用妇科与产科杂志, 2015, 31(2):112-116. doi: 10.7504/fk2015010104. doi: 10.7504/fk2015010104
[5]	Gupta JK, Sood A, Hofmeyr GJ, et al. Position in the second stage of labour for women without epidural anaesthesia[J]. Cochrane Database Syst Rev, 2017, 5(5):CD002006. doi: 10.1002/14651858.CD002006.pub4. doi: 10.1002/14651858.CD002006.pub4
[6]	Lawrence A, Lewis L, Hofmeyr GJ, et al. Maternal positions and mobility during first stage labour[J]. Cochrane Database Syst Rev, 2013(10): CD003934. doi: 10.1002/14651858.CD003934.pub4. doi: 10.1002/14651858.CD003934.pub4
[7]	Zhang H, Huang S, Guo X, et al. A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China[J]. Midwifery, 2017, 50:117-124. doi: 10.1016/j.midw.2017.03.022. doi: 10.1016/j.midw.2017.03.022
[8]	Tunestveit JW, Baghestan E, Natvig GK, et al. Factors associated with obstetric anal sphincter injuries in midwife-led birth: A cross sectional study[J]. Midwifery, 2018, 62:264-272. doi: 10.1016/j.midw.2018.04.012. doi: S0266-6138(17)30270-X pmid: 29734121
[9]	Le Ray C, Pizzagalli F. Which interventions during labour to decrease the risk of perineal tears? CNGOF Perineal Prevention and Protection in Obstetrics Guidelines[J]. Gynecol Obstet Fertil Senol, 2018, 46(12):928-936. doi: 10.1016/j.gofs.2018.10.026. doi: S2468-7189(18)30281-2 pmid: 30377092
[10]	Räisänen S, Vehviläinen-Julkunen K, Cartwright R, et al. A prior cesarean section and incidence of obstetric anal sphincter injury[J]. Int Urogynecol J, 2013, 24(8):1331-1339. doi: 10.1007/s00192-012-2006-6. doi: 10.1007/s00192-012-2006-6 pmid: 23212242
[11]	Jardine JE, Knight HE, Carroll FE, et al. Risk of obstetric anal sphincter injury in women having a vaginal birth after a previous caesarean section: A population-based cohort study[J]. Eur J Obstet Gynecol Reprod Biol, 2019, 236:7-13. doi: 10.1016/j.ejogrb.2019.02.004. doi: 10.1016/j.ejogrb.2019.02.004
[12]	Elvander C, Ahlberg M, Edqvist M, et al. Severe perineal trauma among women undergoing vaginal birth after cesarean delivery: A population-based cohort study[J]. Birth, 2019, 46(2):379-386. doi: 10.1111/birt.12402. doi: 10.1111/birt.12402
[13]	Elvander C, Ahlberg M, Thies-Lagergren L, et al. Birth position and obstetric anal sphincter injury: a population-based study of 113 000 spontaneous births[J]. BMC Pregnancy Childbirth, 2015, 15:252. doi: 10.1186/s12884-015-0689-7. doi: 10.1186/s12884-015-0689-7
[14]	Thies-Lagergren L, Uldbjerg T, Maimburg RD. Genital tract tears in women giving birth on a birth seat: A cohort study with prospectively collected data[J]. Women Birth, 2020, 33(1):15-21. doi: 10.1016/j.wombi.2018.12.006. doi: S1871-5192(18)30316-0 pmid: 30642782
[15]	Bellussi F, Ghi T, Youssef A, et al. Intrapartum Ultrasound to Differentiate Flexion and Deflexion in Occipitoposterior Rotation[J]. Fetal Diagn Ther, 2017, 42(4):249-256. doi: 10.1159/000457124. doi: 10.1159/000457124
[16]	Siccardi M, Valle C, Di Matteo F. Dynamic External Pelvimetry Test in Third Trimester Pregnant Women: Shifting Positions Affect Pelvic Biomechanics and Create More Room in Obstetric Diameters[J]. Cureus, 2021, 13(3):e13631. doi: 10.7759/cureus.13631. doi: 10.7759/cureus.13631
[17]	Hemmerich A, Diesbourg T, Dumas GA. Development and validation of a computational model for understanding the effects of an upright birthing position on the female pelvis[J]. J Biomech, 2018, 77:99-106. doi: 10.1016/j.jbiomech.2018.06.013. doi: S0021-9290(18)30444-5 pmid: 29970228
[18]	Hemmerich A, Bandrowska T, Dumas GA. The effects of squatting while pregnant on pelvic dimensions: A computational simulation to understand childbirth[J]. J Biomech, 2019, 87:64-74. doi: 10.1016/j.jbiomech.2019.02.017. doi: S0021-9290(19)30147-2 pmid: 30851977
[19]	Huang J, Zang Y, Ren LH, et al. A review and comparison of common maternal positions during the second-stage of labor[J]. Int J Nurs Sci, 2019, 6(4):460-467. doi: 10.1016/j.ijnss.2019.06.007. doi: 10.1016/j.ijnss.2019.06.007
[20]	Desseauve D, Fradet L, Lacouture P, et al. Position for labor and birth: State of knowledge and biomechanical perspectives[J]. Eur J Obstet Gynecol Reprod Biol, 2017, 208:46-54. doi: 10.1016/j.ejogrb.2016.11.006. doi: S0301-2115(16)31018-1 pmid: 27888706
[21]	Desseauve D, Pierre F, Fernandez A, et al. Assessment of Pelvic-Lumbar-Thigh Biomechanics to Optimize The Childbirth Position: An "In Vivo" Innovative Biomechanical Study[J]. Sci Rep, 2019, 9(1):15968. doi: 10.1038/s41598-019-52338-8. doi: 10.1038/s41598-019-52338-8 pmid: 31685875
[22]	Bueno-Lopez V, Fuentelsaz-Gallego C, Casellas-Caro M, et al. Efficiency of the modified Sims maternal position in the rotation of persistent occiput posterior position during labor: A randomized clinical trial[J]. Birth, 2018, 45(4):385-392. doi: 10.1111/birt.12347. doi: 10.1111/birt.12347 pmid: 29537658
[23]	Le Ray C, Lepleux F, De La Calle A, et al. Lateral asymmetric decubitus position for the rotation of occipito-posterior positions: multicenter randomized controlled trial EVADELA[J]. Am J Obstet Gynecol, 2016, 215(4):511.e1-e7. doi: 10.1016/j.ajog.2016.05.033. doi: 10.1016/j.ajog.2016.05.033
[24]	Liu LP, Chen JH, Yang ZJ, et al. Corrective effects of maternal extreme flexure and hip abduction combined with contralateral side-lying on persistent foetal occipito-posterior position[J]. Int J Nurs Pract, 2018, 24(5):e12663. doi: 10.1111/ijn.12663. doi: 10.1111/ijn.12663
[25]	张静. 自由体位分娩的研究进展[J]. 中华现代护理杂志, 2018, 24(5):617-620. doi: 10.3760/cma.j.issn.1674-2907.2018.05.032. doi: 10.3760/cma.j.issn.1674-2907.2018.05.032
[26]	Borges M, Moura R, Oliveira D, et al. Effect of the birthing position on its evolution from a biomechanical point of view[J]. Comput Methods Programs Biomed, 2021, 200:105921. doi: 10.1016/j.cmpb.2020.105921. doi: 10.1016/j.cmpb.2020.105921
[27]	Alhafez L, Berghella V. Evidence-based labor management: first stage of labor (part 3)[J]. Am J Obstet Gynecol MFM, 2020, 2(4):100185. doi: 10.1016/j.ajogmf.2020.100185. doi: 10.1016/j.ajogmf.2020.100185
[28]	Simarro M, Espinosa JA, Salinas C, et al. A Prospective Randomized Trial of Postural Changes vs Passive Supine Lying during the Second Stage of Labor under Epidural Analgesia[J]. Med Sci(Basel), 2017, 5(1):5. doi: 10.3390/medsci5010005. doi: 10.3390/medsci5010005
[29]	Berta M, Lindgren H, Christensson K, et al. Effect of maternal birth positions on duration of second stage of labor: systematic review and meta-analysis[J]. BMC Pregnancy Childbirth, 2019, 19(1):466. doi: 10.1186/s12884-019-2620-0. doi: 10.1186/s12884-019-2620-0
[30]	Moraloglu O, Kansu-Celik H, Tasci Y, et al. The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women[J]. J Matern Fetal Neonatal Med, 2017, 30(2):245-249. doi: 10.3109/14767058.2016.1169525. doi: 10.3109/14767058.2016.1169525 pmid: 27028537
[31]	Grylka-Baeschlin S, Petersen A, Karch A, et al. Labour duration and timing of interventions in women planning vaginal birth after caesarean section[J]. Midwifery, 2016, 34:221-229. doi: 10.1016/j.midw.2015.11.004. doi: S0266-6138(15)00287-9 pmid: 26681573
[32]	Rusavy Z, Francova E, Paymova L, et al. Timing of cesarean and its impact on labor duration and genital tract trauma at the first subsequent vaginal birth: a retrospective cohort study[J]. BMC Pregnancy Childbirth, 2019, 19(1):207. doi: 10.1186/s12884-019-2359-7. doi: 10.1186/s12884-019-2359-7
[33]	Rottenstreich M, Futeran Shahar C, Rotem R, et al. Duration of first vaginal birth following cesarean: Is stage of labor at previous cesarean a factor?[J]. Eur J Obstet Gynecol Reprod Biol, 2020, 252:344-348. doi: 10.1016/j.ejogrb.2020.06.060. doi: S0301-2115(20)30435-8 pmid: 32659640
[34]	Paternotte J, Potin J, Diguisto C, et al. Delivery in lateral position. Comparative study in low risk pregnancy between lateral and dorsal position for the delivery in eutocic vaginal birth[J]. Gynecol Obstet Fertil, 2012, 40(5):279-283. doi: 10.1016/j.gyobfe.2011.07.039. doi: 10.1016/j.gyobfe.2011.07.039 pmid: 22018847