PMID: 3311133Aug 1, 1987

Maternal posture in second stage and fetal acid base status

British Journal of Obstetrics and Gynaecology
F D JohnstoneA K Harouny

Abstract

The effect of position during the second stage on outcome was studied in 58 women, with no exclusions because of pregnancy complications or signs of fetal distress, who were randomly allocated to have the second stage conducted in either the dorsal or 15 degrees lateral tilt position. All the women were of parity 0 or 1 and the two groups were well matched except for gestational age at delivery. There were no differences in clinical outcome between the two groups, but overall the dorsal group had lower cord artery pH values (P less than 0.05), higher PCO2 (P less than 0.01) and a greater base deficit, but not significantly so. pH and base deficit were similar in both groups where the second stage did not last greater than 15 min. Thereafter, there was a trend to decreasing pH and increasing base deficit with increasing length of second stage in the dorsal group, but not in the tilt group though this did not reach statistical significance. Low Apgar scores, complicated pregnancy and first pregnancy were each associated with significantly lower pH levels. Prolonged placement of the patient in the flat dorsal position should be avoided in second stage, though a suitable alternative under the conditions described has not been defined.

References

Sep 1, 1979·British Journal of Obstetrics and Gynaecology·T Weber, S Hahn-Pedersen
Aug 1, 1974·The Journal of Obstetrics and Gynaecology of the British Commonwealth·M HumphreyD Hounslow
Dec 1, 1973·The Journal of Obstetrics and Gynaecology of the British Commonwealth·M HumphreyC Wood
Feb 27, 1982·Lancet·G S SykesA C Turnbull
May 1, 1980·Obstetrics and Gynecology·W J Ledger

Citations

May 1, 1995·European Journal of Obstetrics, Gynecology, and Reproductive Biology·R Scherer, W Holzgreve
Apr 3, 2001·BJOG : an International Journal of Obstetrics and Gynaecology·L NordströmS Arulkumaran
May 1, 1992·British Journal of Obstetrics and Gynaecology·N S SaundersJ Wadsworth
Jul 21, 2011·Asian Pacific Journal of Tropical Medicine·Wei-hong LiSong Jin
May 26, 2017·The Cochrane Database of Systematic Reviews·Janesh K GuptaJoshua P Vogel
Sep 21, 2004·Journal of Psychosomatic Obstetrics and Gynaecology·A De JongeA L M Lagro-Janssen
Feb 1, 1988·British Journal of Obstetrics and Gynaecology·D P Barton

Related Concepts

Clinical Trials
Fetal Structures
Hydrogen-Ion Concentration
Labor (Childbirth)
Labor Stage, Second
Randomization
Supination

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