CHILD BIRTH

Abstract

Objectives: The purpose of the study was to compare the complications ofdelivery in squatting and lithotomy position of mother. Study Design: Randomized controlledtrial. Setting: Gynecology/Obstetrics Unit-II, Sandeman Provincial Teaching Hospital, Quetta.Period: 6 months (05 Oct, 2011 to 05 April, 2012) Methods: Hundred and fifty one patients withlithotomy position in delivery were compared with hundred and fifty one patients with squattingposition in delivery regarding risks of perineal tears, periurethral tear, extended episiotomy,instrumental delivery, caesarean section and primary postpartum hemorrhage. Data wasrecorded on a specially designed Performa and was analyzed by using SPSS.V. 10. Resultswere compared using Chi-square test by keeping the p-value of < 0.05 as significant. Results:151 patients in lithotomy position and 151 patients in squatting position were compared andstudied for complications during delivery. Extension of the episiotomy was observed in (7%) ofnon-squatting groups. There were no extensions of episiotomy in squatting group. There wereno second degree, or third degree perineal tears in squatting group which were encounteredin (9%) patients in the lithotomy position group (P<0.05). Forceps application was also lessin squatting position group 11% patients, whereas 24% patients were delivered by forcepsin lithotomy group, (P<0.05). One patient in the lithotomy position had to have a caesareansection due to persistent occipito-posterior position. There was no case of retained placentaor postpartum hemorrhage in squatting group whereas there were 4% cases of retainedplacenta and 1 case of postpartum hemorrhage due to atony of the uterus in lithotomy positiongroup. Conclusions: It appears that the routine use of lithotomy position may have somedisadvantages in terms of more instrumental deliveries and episiotomies. Moreover womenexperience significant pain in this position. It is suggested that more trials should be conductedand the position at the moment of birth should be registered to measure its influence on birthoutcome.