A meta-analysis of the effect on maternal health of upright positions during the second stage of labour, without routine epidural analgesia

作者：Deliktas Ayse; Kukulu Kamile^*

来源：Journal of Advanced Nursing, 2018, 74(2): 263-278.

DOI：10.1111/jan.13447

• delivery nursing care
• labour positions
• maternal health
• meta-analysis
• nursing
• parturition
• recumbent positions
• systematic review
• upright positions

AimTo detect the effect on maternal health of upright positions during the second stage of labour.
BackgroundMaternal position during labour has an important effect on maternal and foetal health.
DesignA meta-analysis was used based on the Cochrane Handbook.
Data sourcesRandomized/non-randomized clinical trials were searched with English and Turkish key words in databases (CINAHL, Medline, Science Direct, Springer Link, Ovid, Cochrane Central Register of Controlled Trials, Networked Digital Library of Theses & Dissertations, Proquest, ULAKBM (Turkish Academic Network and Information Center) and YoK (Turkish Council of Higher Education) (1970-December 2015).
Review methodsAccording to inclusion criteria, eligible studies were identified. Data extraction was performed and the bias risks of the studies were assessed independently by two authors. The publication bias of the main outcomes was examined. The overall effect size was calculated by risk ratio with a random effects model. Statistical heterogeneity tests and sensitivity analyses were performed.
ResultsThe criteria for the meta-analysis were met by 22 articles. It was detected that the ratio of instrumental labour and episiotomy was lower but the haemorrhage ratio was higher in women. There was no statistical effect of upright position on the other maternal outcomes.
ConclusionThe reductions in these ratios improved comfort. Due to methodological shortcomings of the studies, the increased ratio of postpartum haemorrhage should be interpreted with caution. Researchers are recommended to conduct studies rigorously. In addition, healthcare professionals are recommended to decide the appropriate birth position by considering the individual risk factors and preferences of the women.

• 出版日期2018-2