Cochrane · systematic review · CD008070
Maternal position in the second stage of labour for women with epidural anaesthesia
Walker, KF, Kibuka, M, Thornton, JG, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
12
No studies
2
Included studies
NR
No studies 2 · 14.3%Ungraded 0 · 0%Very low 5 · 35.7%Low 3 · 21.4%Moderate 2 · 14.3%High 2 · 14.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Show all 2 versionsUpright position compared to recumbent position for the second stage of labour for women with epidural anaesthesia
Population: women in the second stage of labour with epidural anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal outcomes Upright position vs recumbent position | no estimate extracted | NR | No studies |
Operative birth (caesarean or instrumental vaginal) Upright position vs recumbent position | RR 0.86 [0.7, 1.07] | 8 studies · 4316 participants | Low Downgraded: risk of bias, inconsistency |
Duration of second stage labour (minutes) (from time of randomisation to birth) Upright position vs recumbent position | no estimate extracted | 3 studies · 456 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Caesarean section Upright position vs recumbent position | RR 0.94 [0.61, 1.46] | 8 studies · 4316 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Instrumental vaginal birth Upright position vs recumbent position | RR 0.9 [0.72, 1.12] | 8 studies · 4316 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Trauma to birth canal requiring suturing Upright position vs recumbent position | RR 1 [0.89, 1.13] | 3 studies · 3266 participants | Low Downgraded: risk of bias, inconsistency |
Blood loss (greater than 500 mL) (trial authors defined it as PPH requiring blood transfusion) Upright position vs recumbent position | RR 1.2 [0.83, 1.72] | 1 study · 3093 participants | Moderate Downgraded: risk of bias, imprecision |
Infant outcomes Upright position vs recumbent position | no estimate extracted | NR | No studies |
Abnormal fetal heart rate patterns, requiring intervention Upright position vs recumbent position | RR 1.69 [0.32, 8.84] | 1 study · 107 participants | Very low Downgraded: risk of bias, imprecision |
Low cord pH Upright position vs recumbent position | RR 0.43 [0.2, 0.9] | 2 studies · 3159 participants | Moderate Downgraded: risk of bias |
Admission to neonatal intensive care unit Upright position vs recumbent position | RR 0.54 [0.02, 12.73] | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision |
Upright position compared to recumbent position (sensitivity analyses ‐ studies at low risk of bias only) for the second stage of labour for women with epidural anaesthesia
Population: women in the second stage of labour with epidural anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Operative birth (caesarean or instrumental vaginal) Upright position vs recumbent position (sensitivity analyses ‐ studies at low risk of bias only) | RR 1.11 [1.03, 1.2] | 3 studies · 3609 participants | High |
Caesarean section Upright position vs recumbent position (sensitivity analyses ‐ studies at low risk of bias only) | RR 1.29 [1.05, 1.57] | 3 studies · 3609 participants | High |
Instrumental vaginal birth Upright position vs recumbent position (sensitivity analyses ‐ studies at low risk of bias only) | RR 1.08 [0.91, 1.3] | 3 studies · 3609 participants | Low Downgraded: risk of bias, imprecision, inconsistency |