Acta obstetricia et gynecologica Scandinavica
-
Acta Obstet Gynecol Scand · Aug 2005
Review Meta Analysis Comparative StudyA meta-analysis of upright positions in the second stage to reduce instrumental deliveries in women with epidural analgesia.
Epidural analgesia is associated with an increased risk of instrumental delivery. We, in this study, present a systematic review in order to assess the effectiveness of maintaining an upright position during the second stage of labor to reduce instrumental deliveries among women choosing epidural analgesia. The study population included women with uncomplicated pregnancies at term with epidural analgesia established in the first stage of labor. ⋯ There were insufficient data to show a significant benefit from upright positions in the second stage of labor for women who choose epidural or to evaluate safety aspects. However the magnitude of the reductions in instrumental delivery and cesarean section warrants an adequately powered randomized, controlled trial to fully evaluate the practice of upright positions in the second stage for women with an epidural.