Upright positions in childbirth and the prevention of perineal lacerations: a systematic review and meta-analysis

Authors

DOI:

https://doi.org/10.1590/s1980-220x2018027503610%20

Keywords:

Obstretric Nursing, Parturition, Modalities, Position, Lacerations, Review, Meta-Analysis

Abstract

Objective To investigate whether the adoption of upright positions by women during childbirth prevents perineal lacerations compared to the lithotomy position. Method A systematic review with meta-analysis. The searches were carried out in the databases: LILACS, Medline/PubMed, CINAHL, Cochrane Library, Web of Science, Science Direct and Scopus. Searches in the gray literature were conducted on Google Scholar and OpenGrey databases. Reference lists of included articles were also considered. The Cochrane collaboration tool and ACROBAT-NRSI were used to analyze the methodological quality of the articles. Results There were 26 studies listed and 8 were selected for the meta-analysis. The level of scientific evidence was classified by the GRADE System and considered high. There was no statistically significant difference between upright positions in relation to horizontal positions. Despite this finding, the upright positions showed reduced rates of severe perineal lacerations. Conclusion Adopting upright positions in normal delivery can be encouraged by professionals as it can prevent severe perineal lacerations; however, it is not possible to accurately affirm their effectiveness to the detriment of horizontal positions for an intact perineum outcome.

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Published

2020-09-14

Issue

Section

Review

How to Cite

Upright positions in childbirth and the prevention of perineal lacerations: a systematic review and meta-analysis. (2020). Revista Da Escola De Enfermagem Da USP, 54, e03610. https://doi.org/10.1590/s1980-220x2018027503610