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

Authors

  • María Domínguez-Mejías Hospital Materno-Infantil. Málaga. España.
  • Laura Falcón Carvajal Hospital Materno-Infantil. Málaga. España.

DOI:

https://doi.org/10.51326/ec.5.1.3918587

Keywords:

labor presentation, modalities position, rotation, nurse midwives.

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.

Downloads

Download data is not yet available.

References

Albillos Alonso, L., Espinilla Sanz, B., Tomé Blanco, E. et al. (2018) “Alteraciones del objeto, del motor y del canal del parto”. En: Espinilla Sanz, B., Tomé Blanco, E., Sadornil Vicario, M.E. et al. (Eds.) Manual de obstetricia para matronas. 4ª ed. Valladolid: Difacil.

Bueno-Lopez, V., Fuentelsaz-Gallego, C., Casellas-Caro, M., Falgueras-Serrano, A.M., Crespo-Berros, S., Silvano-Cocinero, A.M. et al. (2018) “Efficiency of the modified Sims maternal position in the rotation of persistent occiput posterior position during labor: A randomized clinical trial”, Birth, 45(4), pp. 385-392. https://doi.org/10.1111/birt.12347

Bueno-López, V., Terré-Rull, C., Casellas-Caro, M. y Fuentelsaz-Gallego, C. (2015) “El impacto y la corrección de posiciones occipitoposteriores en el parto”, Matronas Profesión, 16(4), pp. 118-123. Disponible en: https://matronasprofesion.es/archivo/vol-16-num-4-2015/?ver=3-1-1 [Consultado 25-01-2021]

Castel, P., Bretelle, F., D’Ercole, C. y Blanc, J. (2019) “Pathophysiology, diagnosis and management of occiput posterior presentation during labor”, Gynécologie Obstétrique, Fertilité & Sénologie, 47(4), pp. 370-377. https://doi.org/10.1016/j.gofs.2019.02.002

Cheng, Y.W., Shaffer, B.L. y Caughey, A.B. (2006) “The Association Between Persistent Occiput Posterior Position and Neonatal Outcomes”, Obstetrics & Gynecology, 107(4), pp. 837-844. https://doi.org/10.1097/01.AOG.0000206217.07883.a2

Desbriere, R., Blanc, J., Le Dû, R., Renner, J.P., Carcopino, X., Loundou, A. et al. (2013) “Is maternal posturing during labor efficient in preventing persistent occiput posterior position? A randomized controlled trial”, AJOG, 208(1), pp. 60.E1-60.E8. Disponible en: https://www.ajog.org/article/S0002-9378(12)02029-7/fulltext [Consultado 25-01-2021]

Fitzpatrick, M., McQuillan, K. y O’Herlihy, C. (2001) “Influence of Persistent Occiput Posterior Position on Delivery Outcome”. Obstetrics & Gynecology, 98(6), pp. 1027-1031. Disponible en: https://journals.lww.com/greenjournal/Abstract/2001/12000/Influence_of_Persistent_Occiput_Posterior_Position.7.aspx [Consultado 25-01-2021]

Guittier, M.J., Othenin-Girard, V., Gasquet, B., Irion, O. y Boulvain, M. (2016) “Maternal positioning to correct occiput posterior fetal position during the first stage of labour: A randomised controlled trial”, BJOG, 123(13), pp. 2199-2207. https://doi.org/10.1111/1471-0528.13855

Hirsch, E., Elue, R., Wagner, A., Nelson, K., Silver, R.K., Zhou, Y. et al. (2014) “Severe perineal laceration during operative vaginal delivery: The impact of occiput posterior position”, Journal of Perinatology, 34(12), pp. 898-900. https://doi.org/10.1038/jp.2014.103

Laílla Vicens, J.M., González Bosquet, E., Sol Fernández, J.R. y González-Merlo, J. (2018) “Distocias del parto: del motor, del canal y del objeto del parto”. En: González-Merlo, J., Laílla Vicens, J.M., Fabre González, E. y González Bosquet, E. (Eds.) Obstericia. 7ª ed. Barcelona: Elsevier.

Le Ray, C., Lepleux, F., La Calle, A., Guerin, J., Sellam, N., Dreyfus, M. et al. (2016) “Lateral asymmetric decubitus position for the rotation of occipito-posterior positions: multicenter randomized controlled trial EVADELA”, AJOG, 215(4), pp. 511.E1-511.E7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27242201/ [Consultado 27-01-2021]

Molina Reyes, C. y Muñoz Martinez, A.L. (2009) “La malposición fetal occipito-posterior. Revisión bibliográfica”, Metas de Enfermería, 12(7), pp. 22-26. Disponible en: https://www.enfermeria21.com/revistas/metas/articulo/11805/la-malposicion-fetal-occipito-posterior-revision-bibliogrfica/ [Consultado 05-01-2021]

Othenin-Girard, V., Boulvain, M. y Guittier, M.J. (2018) “Occiput posterior presentation at delivery: Materno-foetal outcomes and predictive factors of rotation”, Gynécologie Obstétrique Fertilité & Sénologie, 46(2), pp. 93-98. https://doi.org/10.1016/j.gofs.2017.11.006

Ponkey, S.E., Cohen, A.P., Heffner, L.J., Lieberman, E. y Ellice, M.D. (2003) “Persistent Fetal Occiput Posterior Position”. Obstetrics & Gynecology, 101(5), pp. 915-920. Disponible en: https://journals.lww.com/greenjournal/Abstract/2003/05000/Persistent_Fetal_Occiput_Posterior_Position_.16.aspx [Consultado 25-01-2021]

Salvador Sabés, B. e Isar Malo, P. (2013) “Parto distócico”. En: Castán Mateo, S. y Tobajas Homs, J.J. (Dirs.) Obstetricia para matronas. Guia práctica. Madrid: Panamericana.

Stremler, R., Hodnett, E., Petryshen, P., Stevens, B., Weston, J. y Willan, A.R. (2005) “Randomized controlled trial of hands-and-knees positioning for occipitoposterior position in labor”, Birth, 32(4), pp. 243-251. https://doi.org/10.1111/j.0730-7659.2005.00382.x

Published

2022-01-19

How to Cite

1.
Domínguez-Mejías M, Falcón Carvajal L. Effectiveness of maternal postural changes on the occipitoposterior position of the fetal head. Enferm. cuid. [Internet]. 2022 Jan. 19 [cited 2024 Dec. 26];5(1):14-9. Available from: https://enfermeriacuidandote.com/article/view/4298