Labour augmentation and fetal outcomes in relation to birth positions: a secondary analysis of an RCT evaluating birth seat births.
OBJECTIVE
the aim of this study was to compare the use of synthetic oxytocin for augmentation, duration of labour and birth and infant outcomes in nulliparous women randomised to birth on a birth seat or any other position.


METHODS
a randomised controlled trial in Sweden where 1002 women were randomised to birth on a birth seat (experimental group) or birth in any other position (control group). Data were collected between November 2006 and July 2009. The outcome measurements included synthetic oxytocin augmentation, duration of the second stage of labour and fetal outcome. Analysis was by intention to treat.


METHODS
southern Sweden.


RESULTS
the main findings of this study were that women randomised to the experimental group had a statistically significant shorter second stage of labour than women randomised to the control group. There were no differences between the groups for use of synthetic oxytocin augmentation or for neonatal outcomes.


CONCLUSIONS
women allocated to the birth seat had a significantly shorter second stage of labour despite similar numbers of women subjected to synthetic oxytocin augmentation in the study groups. The adverse neonatal outcomes did not differ between groups. The birth seat can be suggested as non-medical intervention used to reduce duration of second stage labour and birth. The birth seat can be suggested as a non-medical intervention that may facilitate reduced duration of the second stage of labour. Furthermore it is recommended that caregivers, both midwives and midwifery students, should learn skills to assist women in using a variety of birth positions.


BACKGROUND
unique Protocol ID: Dnr 2009/739 (register.clinicaltrials.gov).
Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden. li.thies-lagergren@skane.se
Li
L
Thies-Lagergren
Linda J
LJ
Kvist
Ann-Kristin
AK
Sandin-Bojö
Kyllike
K
Christensson
Ingegerd
I
Hildingsson
D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007748:Labor Stage, Second; D007751:Labor, Induced / Q000379:methods / Q000706:statistics & numerical data; D008880:Midwifery / Q000379:methods*; D010120:Oxytocics / Q000008:administration & dosage; D010121:Oxytocin / Q000008:administration & dosage*; D010298:Parity; D056888:Patient Positioning / Q000379:methods / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D013548:Sweden; D013997:Time Factors
D010120:Oxytocics; D010121:Oxytocin