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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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https://afar.info/id=1165

Created on : 21 Apr 2005
Modified on : 24 Nov 2018

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Bibliographical entry (without author) :

A randomized trial of birthing stool or conventional semirecumbent position for second-stage labor. Birth. 1991 Mar;18(1):5-10.

Author(s) :

Waldenstrom U, Gottvall K.

Year of publication :

1991

URL(s) :

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.…
https://doi.org/10.1111/j.1523-536X.1991.tb00045.x

Résumé (français)  :

Deux cent quatre-vingt-quatorze femmes ont été réparties au hasard dans un groupe dans lequel l’utilisation d’une chaise d’accouchement (groupe expérimental) ou d’une position conventionnelle demi-assise (groupe témoin) a été encouragée. La chaise d’accouchement avait une hauteur de 32 cm et permettait à la parturiente de s’asseoir et de s’accroupir. Le mari pouvait s’asseoir derrière sa femme et la soutenir en retour. Aucune différence n’a été observée entre les deux groupes en ce qui concerne le mode d’accouchement, la durée du deuxième stade du travail, l’augmentation de l’ocytocine, les traumatismes périnéaux, les lacérations labiales ou l’œdème vulvaire. Les résultats chez les nouveau-nés mesurés par les scores Apgar à 1 et 5 minutes après l’accouchement et le nombre de transferts d’unités de soins intensifs néonatals étaient les mêmes dans les deux groupes. Les pertes sanguines moyennes estimées et le nombre de mères présentant une hémorragie postpartum de 600 ml ou plus étaient plus importants dans le groupe expérimental que dans le groupe témoin. Les femmes du groupe expérimental ont signalé moins de douleur pendant le deuxième stade du travail, et elles-mêmes et leur conjoint étaient plus satisfaits de la position de naissance que les parents du groupe témoin. Les sages-femmes étaient moins satisfaites de leur posture de travail dans le groupe expérimental.

Abstract (English)  :

Two hundred ninety-four women were randomly allocated to a group in which the use of a birthing stool (experimental group) or a conventional semirecumbent position (control group) was encouraged. The birthing stool was 32 cm high and allowed the parturient to sit upright and to squat. The husband could sit close behind his wife and support her back. No differences were observed between the two groups regarding mode of delivery, length of the second stage of labor, oxytocin augmentation, perineal trauma, labial lacerations, or vulvar edema. Infant outcome measured by Apgar scores at 1 and 5 minutes postpartum and numbers of neonatal intensive care unit transfers was the same in both groups. Mean estimated blood loss and the number of mothers with a postpartum hemorrhage 600 ml or more were greater in the experimental group than in the control group. Women in the experimental group reported less pain during the second stage of labor, and they and their spouses were more satisfied with the birth position than were parents in the control group. Midwives were less satisfied with their working posture in the experimental group.

Sumário (português)  :

Duzentos e noventa e quatro mulheres foram aleatoriamente designados para um grupo em que o uso de em cadeira de parto (grupo experimental) ou uma posição convencional de meia-sessão (grupo controle) foi incentivada. A cadeira de parto tinha uma altura de 32 cm e permitia que a parturiente sentasse e agachasse. O marido podia se sentar atrás de sua esposa e apoiá-la em troca. Não foram observadas diferenças entre os dois grupos no modo de parto, duração do segundo estágio do trabalho de parto, aumento da ocitocina, trauma perineal, lacerações labiais ou edema vulvar. Os resultados em neonatos medidos pelos escores de Apgar em 1 e 5 minutos após o parto e o número de transferências de unidade de terapia intensiva neonatal foram os mesmos em ambos os grupos. A perda sanguínea média estimada e o número de mães com hemorragia pós-parto de 600 ml ou mais foram maiores no grupo experimental do que no grupo controle. As mulheres do grupo experimental relataram menos dor durante o segundo estágio do trabalho de parto, e elas e seus cônjuges ficaram mais satisfeitas com a posição de nascimento do que os pais do grupo de controle. As parteiras estavam menos satisfeitas com a postura de trabalho no grupo experimental.

Comments :

Argument (français) :

La chaise d’accouchement (avec le mari en soutien) versus la position semi-assise. Seules différences : perte de sang plus importante sur la chaise, sages-femmes moins satisfaites, mais second stade du travail moins douloureux.

Argument (English):

The birthing chair (with the husband in support) versus semi-sitting position. Only differences: more blood loss on the chair, less satisfied midwives, but second stage of work less painful.

Argumento (português):

A cadeira de parto (com o marido em apoio) versus a posição semi-sentada. Só diferenças: mais perda de sangue nas cadeira, parteiras menos satisfeitas, mas segundo estágio do trabalho menos doloroso.

Keywords :

➡ evidence-based medicine/midwifery ; physiology ; position during labor ; psychology ; perineal/vaginal tears ; postpartum hemorrhage ; fetal distress ; oxytocin

Author of this record :

Cécile Loup — 21 Apr 2005
➡ latest update : Bernard Bel — 24 Nov 2018

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#1181   McManus TJ, Calder AA. (1978). Upright posture and the efficiency of labour. Lancet. 1978 Jan 14;1(8055):72-4. ➡ https://afar.info/id=1181
#1174   Gardosi J, Hutson N, B-Lynch C. (1989). Randomised, controlled trial of squatting in the second stage of labour. Lancet. 1989 Jul 8;2(8654):74-7. ➡ https://afar.info/id=1174
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#1177   Liddell HS, Fisher PR. (1985). The birthing chair in the second stage of labour. Aust N Z J Obstet Gynaecol. 1985 Feb;25(1):65-8. ➡ https://afar.info/id=1177
#1175   Hemminki E, Virkkunen A, Makela A, et al. (1986). A trial of delivery in a birth chair. Journal of Obstetrics & Gynaecology 1986;6:162-5. ➡ https://afar.info/id=1175
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#975   Crowley P, Elbourne D, Ashurst H, Garcia J, Murphy D, Duignan N. (1991). Delivery in an obstetric birth chair: a randomized controlled trial. Br-J-Obstet-Gynaecol. 1991 Jul; 98(7): 667-74 ➡ https://afar.info/id=975
------ out of group ------
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