Squatting position in the second stage of labor: A systematic review and meta-analysis.

Details

Serval ID
serval:BIB_9553A2AC10A1
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Squatting position in the second stage of labor: A systematic review and meta-analysis.
Journal
European journal of obstetrics, gynecology, and reproductive biology
Author(s)
Dokmak F., Michalek I.M., Boulvain M., Desseauve D.
ISSN
1872-7654 (Electronic)
ISSN-L
0301-2115
Publication state
Published
Issued date
11/2020
Peer-reviewed
Oui
Volume
254
Pages
147-152
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
The influence of squatting during delivery on maternal and fetal outcomes remains unclear. We performed a systematic review and meta-analysis to evaluate the benefits and risks of adopting a squatting position during the second stage of labor.
Search Strategy: A systematic search in the three major electronic databases (CENTRAL, PubMed and Embase) was performed, from their respective inception dates to the 14th of December 2019, using 'squatting', and a combination of keywords to identify delivery. Eligibility criteria: Randomized controlled trials comparing squatting position to any supine position during the second stage of labor.
Risk ratio for dichotomous outcomes, mean difference for continuous outcomes, with 95 % confidence intervals. Fixed-effects meta-analysis (Mantel-Haenszel method) or random-effects model (inverse variance method), for low and high heterogeneity between trials, respectively. PROSPERO Registration number: CRD42018093244 RESULTS: Seven randomized controlled trials (n = 1219) were included. Three studies were assessed as low risk of bias, three others as moderate and one study as high risk of bias. The main limitation is the lack of reporting on the methods to achieve randomization and concealment of allocation in most of the studies. There was no difference in the duration of the second stage of labor (mean -11.09 min; 95 %CI -38.85 to 16.68). In the squatting group, the risk of caesarean section was increased (RR 2.26, 95 %CI 1.07-4.80) and the risk of instrumental delivery was decreased (RR 0.60, 95 %CI 0.45-0.81), which results in a similar probability of spontaneous delivery. There were no differences regarding the other maternal and fetal outcomes.
The available evidence does not show the squatting position during childbirth to be beneficial. As there is no evidence for or against squatting, women should be able to choose the position they prefer.
Keywords
Delivery, Obstetric, Parturition, Position, Squatting
Pubmed
Web of science
Create date
26/09/2020 14:40
Last modification date
21/01/2021 6:26
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