الفهرس 
Effect of Upright Position During First Stage of Labour On Labour Outcome: An Evidence Based Approach
AbstractOnly 14 pages are availabe for public view
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Abstract
Maternal positioning during labor especially up right position may affect course of labor as related to powers, passage, passenger and psyche. It considered one of non-pharmacological methods that have been proposed to reduce labor pain, fatigue, need for analgesia. and increasing maternal comfort.The aim of the current study was of two folds:1) Perform randomized control study to examine the impact of different upright versus recumbent positions for primipara women in the first stage of labor on labor outcomes.2) Develop systematic review to analyze previous studies related to upright and recumbent positions for women in the first stage of labour on maternal &neonatal outcomes in addition to findings of the current RCT. Two designs were utilized for this study: a randomized control trail as well as a systematic review. Randomized controlled trial (RCT) was conducted at the Department of Obstetrics and Gynecology at El Manial University hospital, Cairo Governorate, Egypt. A total of100 parturient women were recruited randomly and divided equally into study and control groups using sealed opaque envelops technique. Four tools were utilized for data collection: Structured Interviewing Questionnaire, World Health Organization Partograph, Neonatal Apgar’s score, and visual analogue pain intensity scale. Parturient women in the study group, were encouraged to assume one of the upright positions. The control group received routine hospital care, which included lying down in bed. A randomized controlled trials full –text publications in English form was handled and intervention was women who assumed one of upright positions during first stage of labor, comparison to women who assumed one of the recumbent positions during the same labor stage.The exclusion criteria for the studies in the review was any other design rather than RCT.Research findings revealed that, mean pain score in the study group was significantly lower than the control group (P < 0.05). The mean satisfaction score in the study group was significantly higher than in the control group (P =0.000).The duration of the first stage of labour significantly reduced (P = 0.00) in the study group as compared with control group. No significant differences were observed between both groups in relation to duration of second stage (p= 0.594), and neonatal outcomes first min APGAR (p= 0.183) and fifth minutes (p= 0.367). Also, a total of 75 studies were examined, 49 of them excluded & 8 studies were included with a total of 903 women in the review. Five trials from included study reported significance differences between groups related to duration of first stage of labour in favor of the intervention group with total mean was (8.41hrs) as compared to (10.14hrs) in control group. There were significant differences between the pain scores of the women in upright position (less pain scores) versus recumbent position in five trails (P=.001). There were no significant differences between groups for other outcomes including duration of the second stage of labor, fetal and neonatal outcomes. The study concluded that, there was a clear and important evidence that upright positions in the first stage of labor reduced the duration of labor, pain scores, and were not significant with duration of second stage of labor and babies’ well-being. The study recommended based on clinical evidence women in low-risk labor should be informed of the benefits of upright positions, and encouraged to assume it. And disseminate the protocol of care to be available on clinical setting