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Evidence summaries

Upright Position in the Second Stage of Labour to Reduce Instrumental Deliveries in Women with Epidural Analgesia

Upright position in the second stage of labour might possibly reduce instrumental deliveries, but there is not enough evidence for conclusions, and no data on safety outcomes. Level of evidence: "D"

A systematic review 1 including 2 studies with a total of 291 subjects was abstracted in DARE. There was a statistically non-significant reduction in the risk of instrumental delivery (RR 0.77, 95% CI: 0.46, 1.28) and Caesarean section (RR 0.57, 95% CI: 0.28, 1.16) for women in upright positions compared with recumbent positions. Both studies reported a statistically significant reduction in labour duration associated with upright positions.

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and risk of reporting bias (only published studies reported).

    References

    • Roberts CL, Algert CS, Cameron CA, Torvaldsen S. Acta Obstetricia et Gynecologica Scandinavica 2005;84:794-798. [DARE]

Primary/Secondary Keywords