Format

Send to

Choose Destination
BMC Pregnancy Childbirth. 2017 Nov 14;17(1):377. doi: 10.1186/s12884-017-1556-5.

Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study.

Author information

1
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. kristina.dahlqvist@gmail.com.
2
Department of Obstetrics and Gynaecology, Örnsköldsvik Hospital, SE-891 89, Örnsköldsvik, Sweden. kristina.dahlqvist@gmail.com.
3
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Abstract

BACKGROUND:

To examine the impact of occiput posterior position, compared to occiput anterior position, on neonatal outcomes in a setting where delayed pushing is practiced. The specific aim was to estimate the risk of acidaemia.

METHODS:

Cohort study from a university hospital in Sweden between 2004 and 2012. Information was collected from a local database of 35,546 births. Umbilical artery sampling was routine. Outcomes were: umbilical artery pH < 7.00 and <7.10 and short-term neonatal morbidity. The association between occiput posterior position and neonatal outcomes was examined using logistic regression analysis, presented as adjusted odds ratio (AOR) with 95% confidence interval (CI).

RESULTS:

Of 27,648 attempted vaginal births, 1292 (4.7%) had occiput posterior position. Compared with occiput anterior, there was no difference in pH < 7.00 (0.4% vs. 0.5%) but a higher rate of pH < 7.10 in occiput posterior births (3.8 vs. 5.5%). Logistic regression analysis showed no increased risk of pH < 7.10 (AOR 1.28 95% CI 0.93-1.74) when occiput posterior was compared with occiput anterior births but, an increased risk of Apgar score < 7 at 5 min (AOR 1.84, 95% CI 1.11-3.05); neonatal care admission (AOR 1.68, 95% CI 1.17-2.42) and composite morbidity (AOR 1.66, 95% CI 1.19-2.31).

CONCLUSIONS:

With delayed pushing, birth in occiput posterior compared with anterior position is not associated with acidaemia. The higher risk of neonatal morbidity is of concern and any long-term consequences need to be investigated in future studies.

KEYWORDS:

Acidaemia; Apgar score; Caesarean delivery; Delayed pushing; Labour; Metabolic acidaemia; Neonatal morbidity; Occipito-posterior position; Occiput anterior position; Occiput posterior position

PMID:
29137599
PMCID:
PMC5686821
DOI:
10.1186/s12884-017-1556-5
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center