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Abstract
BackgroundThe prone position is rarely used in medical settings in pregnancy. There is no published information about the prone position in women with preeclampsia. This study examined the feasibility and acceptability of the prone position in pregnant women, and the short-term effect of the prone position on blood pressure (BP) in term healthy pregnant women and in women with preeclampsia.MethodsAfter ethics approval, written consent and trial registration (ACTRN:12615000160538 registered 18/02/2015, date of first participant enrolled 03/03/2015), 50 healthy term pregnant women and 15 women with preeclampsia had BP, heart rate (HR), oxygen saturation (SpO2), respiratory rate (RR), fetal heart rate (FHR) and comfort levels measured in two positions: left lateral, and prone. Measurements were after five minutes rest in each position.ResultsMean ± SD age, gestation and body mass index for healthy pregnant women was 33 ± 4.1 years, 38 ± 1.0 weeks and 27 ± 3.2 kg.m− 2 and for women with preeclampsia was 32 ± 4.7 years, 36 ± 3.4 weeks, 31 ± 5.6 kg.m− 2 respectively. No clinically significant changes occurred in healthy pregnant women in the prone position. Systolic BP was reduced in the prone position in women with preeclampsia (P = 0.019, mean difference − 6.6 mmHg, 95% confidence interval − 11.9 to − 1.3 mmHg). 33% of women with preeclampsia experienced a 10 mmHg or greater reduction in systolic BP in the prone position. 42% of healthy pregnant women and 47% of women with preeclampsia preferred the prone position to lateral.ConclusionsThis is the first study to examine the prone position in women with preeclampsia. For short periods of time the prone position is feasible and comfortable in pregnant women including those at term. The prone position may reduce systolic BP in women with preeclampsia without obvious adverse effects. Larger studies with women lying for longer periods in the prone position are required. Pregnancy should not be a contraindication to the prone position for short periods of time.Trial registrationACTRN:12615000160538
Highlights
The prone position is rarely used in medical settings in pregnancy
There was an increase in maternal heart rate in the prone position compared with the left lateral position (p < 0.001 mean difference 10 Beats per minute (BPM), 95% Confidence interval (CI) 8 to 12 BPM)
The prone position is feasible and comfortable in pregnant women including those at term
Summary
There is no published information about the prone position in women with preeclampsia. The prone position is a position in which a person lies horizontally with chest down and back up. With appropriate pillows it is considered a safe position for pregnant women. The position is utilised in the allied health fields and for relaxation and massage in pregnancy. Preeclampsia is a hypertensive condition of human pregnancy [5]. Worldwide it affects 6.5 million young women. Long-term risks include hypertension, ischaemic heart disease and cerebrovascular disease [9]
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