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International Urogynecology Journal

Published in:

01-09-2012 | Original Article

Alternative model of birth to reduce the risk of assisted vaginal delivery and perineal trauma

Authors: Carolina Walker, Tania Rodríguez, Ana Herranz, José A. Espinosa, Emília Sánchez, Montserrat Espuña-Pons

Published in: International Urogynecology Journal | Issue 9/2012

Abstract

Introduction and hypothesis

This study was conducted to evaluate the effects of an alternative model of birth (AMB) on the incidence of assisted vaginal delivery (AVD) and perineal trauma (PT).

Methods

One hundred ninety-nine women with epidural anesthesia were randomized to a traditional model of birth (TMB) (n = 96) or AMB (n = 103). Women in TMB pushed immediately after complete dilatation and delivered in lithotomy position. In AMB, women followed a postural changes protocol while they delayed pushing and used a specific lateral position for delivery.

Results

AMB was associated with a significant reduction in AVD compared with TMB (19.8% vs 42.1%, p < 0.001). TMB was strongly associated with AVD (OR = 4.49; p < 0.05), which, in turn, was significantly associated with nulliparity (OR = 5.52; p < 0.005) and fetal head unengaged at full dilatation (OR = 5.35; p < 0.05). AMB significantly increased the intact perineum rate compared with TMB (40.3% vs 12.2%, p < 0.001). Episiotomy rate was significantly reduced in AMB (21.0% vs 51.4%, p < 0.001).

Conclusion

A combination of postural changes during the passive expulsive phase of labor and lateral position during active pushing time is associated with reductions in AVD and PT.

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Title: Alternative model of birth to reduce the risk of assisted vaginal delivery and perineal trauma
Authors: Carolina Walker
Tania Rodríguez
Ana Herranz
José A. Espinosa
Emília Sánchez
Montserrat Espuña-Pons
Publication date: 01-09-2012
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 9/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-012-1675-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Alternative model of birth to reduce the risk of assisted vaginal delivery and perineal trauma

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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