For nulliparous women with epidural analgesia, fewer spontaneous vaginal births in upright position
THURSDAY, Oct. 19, 2017 (HealthDay News) — For nulliparous women at term with a singleton cephalic presentation receiving epidural analgesia, lying down in the second stage of labor results in more spontaneous vaginal births than being upright, according to a study published online Oct. 18 in the BMJ.
Debra Bick, Ph.D., from King’s College London, and colleagues conducted a trial in 41 U.K. hospital labor wards involving 3,093 nulliparous women aged 16 years or older at term with a single cephalic presentation. Participants were in the second stage of labor with epidural analgesia and were randomized to an upright (1,556 women) or lying down (1,537 women) position.
The researchers found that there were significantly fewer spontaneous vaginal births in the upright group versus the lying down group (35.2 versus 41.1 percent; adjusted risk ratio, 0.86), representing a 5.9 percent absolute increase in the chance of spontaneous vaginal birth in the lying down group. There was no evidence of between-group differences for most secondary maternal, neonatal, or longer-term outcomes.
“Evidence shows that lying down in the second stage of labor results in more spontaneous vaginal births in nulliparous women with epidural analgesia, with no apparent disadvantages in relation to short- or longer-term outcomes for mother or baby,” the authors write.
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