Maternal Position Research Articles

Modifying maternal sleep position in the third trimester of pregnancy with positional therapy: a randomised pilot trial

ObjectiveTo evaluate whether the percentage of time spent supine during sleep in the third trimester of pregnancy could be reduced using a positional therapy device (PrenaBelt) compared with a sham...

Effect of Maternal Positioning with Occipito-posterior Fetal Position during Labor on Pain Intensity and Satisfaction of Mothers

مقدمه: وضعیت­های اکسی‌پوت خلفی، شایع‌ترین نوع وضعیت‌های نامناسب اکسی‌پوت هستند. افزایش شدت درد مادر و همچنین افزایش نیاز به استفاده از بی‌حسی اپیدورال، یکی از عوارض این وضعیت می­باشد. وضعیت قرارگیری مادر در طول لیبر می­تواند شدت درد وی را تحت تأثیر قرار دهد. مطالعه حاضر با هدف بررسی تأثیر وضعیت مادر در مرحله فعال زایمان بر شدت درد و رضایت مادر انجام شد. روش‌کار: این مطالعه کارآزمایی بالینی در سال 1396 بر روی 180 زن نخست باردار با بارداری تک‌قلو و ترم و دارای جنین با وضعیت اکسی‌پوت خلفی که جهت انجام زایمان به زایشگاه شهرستان رامهرمز مراجعه نمودند، انجام شد. افراد به‌طور تصادفی در یکی از سه گروه وضعیت نیمه دمر (45 نفر)، وضعیت سجده (45 نفر) و وضعیت خوابیده به پشت (90 نفر) قرار گرفتند. نیم ساعت بعد از تصادفی‌سازی تا زمان زایمان، تمام شرکت‌کنندگان به‌طور متناوب (30-15 دقیقه در هر ساعت) در وضعیت­های تعریف شده قرار گرفتند. ابزار گردآوری داده­ها در این مطالعه شامل معیار دیداری سنجش درد و فرم ثبت مشاهدات و معاینات بود. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 24) و آزمون‌های کای دو و آنووا انجام شد. میزان p‌ کمتر از 05/0 معنی‌دار در نظر گرفته شد. یافته‌ها: میانگین شدت درد لیبر در گروه­های مورد مداخله در مقایسه با گروه کنترل به‌طور معنی‌داری کمتر بود (001/0>p). همچنین میزان رضایت مادر در گروه­های مداخله در مقایسه با گروه کنترل بیشتر بود (0001/0>p). نتیجه‌گیری: وضعیت­های نیمه دمر و سجده مادر دارای جنین با وضعیت اکسی‌پوت خلفی در طول فاز فعال زایمان و مرحله دوم زایمان در کاهش درد لیبر و افزایش رضایت مادر سودمند است.

Accuracy of Patient Perception of Supine Sleep.

For clinicians involved in investigating and treating sleep disorders, understanding the accuracy of patient recall of supine sleep would allow informed comparisons between polysomnography (PSG) and patient-reported sleep in patients with supine-predominant obstructive sleep apnea. This study aims to assess the accuracy of patient perception of supine sleep. Prospective observational cohort study, assessing patient perception of total sleep and supine sleep, including duration. Data were analyzed utilizing descriptive statistics, bias-plot (Bland-Altman) analysis, and Spearman correlation (rs) to analyze relationships among continuous data. Total number of patients who underwent PSG was 518, with data from 368 of these patients analyzed. Most of these patients underwent diagnostic PSG (49.2%). Patients were excluded because of missing or incomplete data (n = 133) or immobility (n = 17). Some patients (n = 97, 26%) did not perceive supine sleep, with 34 (35% of those with unperceived supine sleep or 9% of whole group) of these having more than 60 minutes of PSG supine sleep (range 0-305.5 minutes). All "unsure" patients (n = 8, 2.2%) had significant supine sleep recorded (31.5-257.5 minutes). For the presence of any PSG supine sleep, questioning had a sensitivity of 77.9%, specificity 72.7% with positive predictive value of 96.7% and negative predictive value of 24.5%. There was a significant correlation (rs = 0.63, P < .0001) between perceived and PSG supine sleep, but wide limits of agreement (-246.9 to 194.2 minutes). In patients undergoing in-laboratory PSG, the perception of supine sleep predicts the presence of PSG supine sleep. However, questioning patients has a poor negative predictive value and patient estimates of supine sleep duration are inaccurate.

Perineal Trauma in a Low-risk Maternity with High Prevalence of Upright Position during the Second Stage of Labor.

Perineal trauma is a negative outcome during labor, and until now it is unclear if the maternal position during the second stage of labor may influence the risk of acquiring severe perineal trauma. We have aimed to determine the prevalence of perineal trauma and its risk factors in a low-risk maternity with a high incidence of upright position during the second stage of labor. A retrospective cohort study of 264 singleton pregnancies during labor was performed at a low-risk pregnancy maternity during a 6-month period. Perineal trauma was classified according to the Royal College of Obstetricians and Gynecologists (RCOG), and perineal integrity was divided into three categories: no tears; first/second-degree tears + episiotomy; and third and fourth-degree tears. A multinomial analysis was performed to search for associated factors of perineal trauma. From a total of 264 women, there were 2 cases (0.75%) of severe perineal trauma, which occurred in nulliparous women younger than 25 years old. Approximately 46% (121) of the women had no tears, and 7.95% (21) performed mediolateral episiotomies. Perineal trauma was not associated with maternal position (p = 0.285), health professional (obstetricians or midwives; p = 0.231), newborns with 4 kilos or more (p = 0.672), and labor analgesia (p = 0.319). The multinomial analysis showed that white and nulliparous presented, respectively, 3.90 and 2.90 times more risk of presenting perineal tears. The incidence of severe perineal trauma was low. The prevalence of upright position during the second stage of labor was 42%. White and nulliparous women were more prone to develop perineal tears.

Low socioeconomic status increases effects of negative life events on antenatal anxiety and depression

ProblemLow socioeconomic status and prior negative life events are documented risk factors for antenatal anxiety and depression, preterm birth and birth weight. We aimed to asses whether the adverse effects of prior negative life events increase with lower socioeconomic status and which aspects of socioeconomic status are most relevant. MethodsWe performed a population-based cohort study in the Netherlands including 5398 women in their first trimester of pregnancy. We assessed the number of negative life events prior to pregnancy, aspects of paternal and maternal socio-economic position and symptoms of anxiety and depression. Associations of the number of prior negative life events with anxiety, depression, low birth weight and gestational age were quantified. FindingsThe number of prior negative life events, particularly when they had occurred in the two years before pregnancy and maternal aspects of low socioeconomic status (educational level, unemployment and income) were associated with antenatal anxiety and depression. Furthermore, low socioeconomic status increased the adverse effects of prior negative life events. Obstetric outcomes showed similar trends, although mostly not statistically significant. DiscussionLow socioeconomic status and prior negative life events both have an adverse effect on antenatal anxiety and depression. Furthermore, low socioeconomic status increases the adverse impact of prior negative life events on anxiety and depressive symptoms in pregnancy. ConclusionInterventions for anxiety and depression during pregnancy should be targeted particularly to unemployed, less-educated or low-income women who recently experienced negative life events.

The effect of supine positioning on maternal hemodynamics during late pregnancy

Introduction: Recent studies have demonstrated an association between maternal supine sleep position and an increased risk of late stillbirth. During late pregnancy, the gravid uterus compresses the inferior vena cava (IVC) when a woman lies in the supine position. The azygos system of veins is the dominant pathway of collateral venous return back to the heart in the event of acute obstruction of the IVC. It is suggested that this pathway provides adequate collateral venous circulation in the event of IVC compression in the supine position during late pregnancy.Objective: Investigate the effect of supine positioning on maternal hemodynamics during late pregnancy and the role of collateral venous circulation.Methods: Ethics approval was obtained and 12 women with singleton pregnancies between 35- and 38-week gestation underwent magnetic resonance imaging in the supine and left lateral decubitus positions using a Skyra 3T system (Siemens). Phase-contrast images were evaluated to measure cardiac output, blood flow through the azygos vein, and blood flow through the abdominal aorta (AA) and IVC at two levels: at the level of aortic bifurcation and immediately above the renal veins.Results: The supine position was associated with a 16.4% reduction in cardiac output when compared to the left lateral position. In addition, blood flow through the IVC decreased at its origin by 85.3% and by 44.4% at the level of the renal veins. Blood flow through the azygos vein increased in the supine position by 220%. Blood flow through the AA at the level of the renal veins did not differ significantly; however, it is reduced by 32.3% at the level of the aortic bifurcation.Conclusions: Women in late pregnancy experience an increase in collateral venous blood flow when lying supine, likely as a response to marked compression of the IVC in this position. However, cardiac output and aortic blood flow were found to decrease while in the supine position.

Left Lateral Table Tilt for Elective Cesarean Delivery Under Spinal Anesthesia Has No Effect on Neonatal Acid-Base Status

(Anesthesiology. 2017;127(2):241–249) Cesarean delivery in the supine position may result in maternal hypotension, aortocaval compression, and fetal complications. Uterine displacement by left lateral tilt is currently recommended to prevent these outcomes. Tilting was associated with superior neonatal acid-base status in studies during the 1970s. The current use of vasopressor agents to effectively prevent maternal spinal hypotension calls into question the necessity of tilting, particularly since the target tilt of 15 degrees is rarely achieved. This study hypothesized that, using a fluid coload with spinal anesthesia and a phenylephrine infusion to maintain baseline systolic blood pressure, neonatal acid base status would not be affected by maternal position (supine vs. tilted) in women delivering via elective cesarean delivery.

Electronic fetal monitoring is more important than freedom of maternal position in labour: FOR: Position in labour is important but EFM can be vital.

There is universal acceptance (except perhaps by ‘free-birthers’) that there is a likely benefit from some form of fetal surveillance during labour. Currently, the choice is between intermittent auscultation and continuous electronic fetal monitoring (cEFM). Even intermittent ‘auscultation’ is commonly performed using a portable Doppler ultrasound fetal heart detector, the only sensible option if the mother is very obese. Although meta-analyses have shown a statistically significant 30% reduction in stillbirth attributed to asphyxia when cEFM is used rather than auscultation (Vintzileos et al. Obstet Gynecol 1995;85:149–55) and a statistically significant 50% reduction in neonatal convulsions (Thacker et al. Obstet Gynecol 1995;86:613–20), the 2014 UK National Institute of Health and Clinical Excellence guidelines still recommend intermittent auscultation for women ‘without risk factors’ (https://www.nice.org.uk/guidance/cg190). But how many women have/develop risk factors? I analysed 29 443 births from 1988 to 1998 at the West London/Chelsea and Westminster Hospitals and found that 74% had at least one risk factor where cEFM is recommended (maternal age ≥40, diabetes, cardiac or renal disease, antepartum haemorrhage, diastolic blood pressure ≥90 mmHg, non-cephalic presentation, induced or augmented labour, epidural anaesthesia, pyrexia, meconium staining of the amniotic fluid, or labour >12 hours). So in only 26% was cEFM not indicated at some time during labour. How important is posture in labour? I accept that the supine position should be avoided. Williams in 1952 illustrated the adverse effect on uterine activity of the supine position compared with sitting (frequency of contractions doubled and active pressure halved [J Obstet Gynaecol Br Emp 1952; 59:635–641]) and this was corroborated in 1960 by Caldeyro-Barcia (Am J Obstet Gynecol 1960;80:284–90), in 1978 by Turnbull (figure 4.11, Scientific Basis of Obstetrics and Gynaecology, 1978;79–108) and by my personal observations (unpublished). But does any particular position other than supine confer an advantage? Is gravity helpful? Mendez-Bauer suggested in 1975 that standing improved progress in labour, but his comparison was with the supine position (J Perinat Med 1975;3:89–100). When challenged to repeat the study comparing standing with lateral recumbency, he found no difference (Roberts et al. J Reprod Med 1984;29:477–81). In human childbirth, where the baby has to be pushed through a birth canal commonly smaller than the unmoulded fetal head, the driving force is uterine contractions, not gravity. This is elegantly demonstrated by the fact that labour in a birthing pool, where the effect of gravity is negated by the buoyancy of the water, has the same duration as labour on dry land (Cluett & Burns. Cochrane Database Syst Rev 2009;(2):CD000111). These data support the 2014 NICE recommendation that women should be discouraged from being supine but encouraged to adopt any other position they find comfortable. Some women value freedom to move, but in many cases, cEFM is vitally important, and with telemetry there is, in any case, no reason why maternal movement should be restricted. None declared. Completed disclosure of interests form available to view online as supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Electronic fetal monitoring is more important than freedom of maternal position in labour: AGAINST: A biomechanical model of labour suggests that maternal freedom of movement is critical for a good birth.

Electronic fetal monitoring is more important than freedom of maternal position in labour: AGAINST: A biomechanical model of labour suggests that maternal freedom of movement is critical for a good birth.

Factors associated with obstetric anal sphincter injuries in midwife-led birth: A cross sectional study

IntroductionObstetric anal sphincter injurie (OASI) in vaginal births are a serious complication, and are associated with maternal morbidity. Focus on modifiable factors in midwives clinical skills and competences contributing to prevent the occurrence of OASI are essential. The objective of this study was to investigate the association between OASI and factors related to midwife-led birth such as manual support of perineum, active delivery of baby's shoulders, maternal birth position, and pushing and breathing techniques in second stage of labour. MethodsA prospective cross sectional study including primiparous (n = 129) and multiparous (n = 628) women in midwife-led non-instrumental deliveries with OASI (n = 96) or intact perineum (n = 661). Data were collected in a university hospital in Norway with two different birth settings: an alongside midwife-led unit with approximately 1500 births per year and an obstetrical unit with approximately 3500 births per year. In midwife-led births, there were a total of 2.6% OASI and 18.9% intact perineum. ResultsThe sample consisted of 757 women, 12.7% suffered OASI and 87.3% of participating women had an intact perineum. This selected sample compares the most serious outcome (OASI), and the optimal outcome (intact perineum).In primiparous women, 61 women suffered OASI and 68 women had intact perineum, while for multipara women, 35 women suffered OASI and 593 women had intact perineum. There was an increased risk of OASI if women actively pushed when the head was crowning compared to breathing the head out (adjusted OR: 3.10; 95% CI: 1.75 to 5.47). The maternal birth position associated with the lowest risk of OASI was kneeling position (adjusted OR: 0.15; 95% CI: 0.03 to 0.70), supine maternal birth position (adjusted OR: 2.52; 95% CI: 1.04 to 4.90) and oxytocin augmentation more than 30 min in second stage (OR: 1.93; 95% CI: 1.68 to 15.63) were associated with an increased risk of OASI, when adjusting for maternal, foetal, and obstetric factors. ConclusionOur study suggests that actively pushing when the baby's head is crowning, a supine maternal birth position and oxytocin augmentation more than 30 min in second stage, were associated with increased risk of OASI when compared to intact perineum. A kneeling maternal birth position was associated with a decreased risk of OASI.

Study on the influence of the supine adjustment on the posterior position of the fetal occipital position in the parturient with epidural analgesia

Objective To investigate the effect of supine regulating on maternal fetal occiput posterior position during the delivery after epidural analgesia. Methods Totally600 cases of parturient with intravaginal posterior occipital position with 3cm voluntary labor analgesia were selected,who were born in Dalian maternity hospital from October 2015 to October 2016.The (Visual Analogue Scale/Score)VAS pain score at 15min after epidural labor analgesia was as effective as less than 3 points. They were randomly divided into the control group and the observation group by random number table method, with 300 cases in each group.The control group monitored parturient respiration, pulse, blood pressure, heart rate and fetal heart rate according to routine treatment.The control group monitored parturient respiration, pulse, blood pressure, heart rate and fetal heart rate according to routine treatment.In the observation group, except for routine treatment according to the labor process, after the opening of 5cm, the pregnant women were instructed to take the lateral prone position, so that the maternal side and the fetal side of the spinal column should be the same side. To observe the difference between the two groups in the rate of spontaneous vaginal delivery, delivery rate, cesarean section rate, fetal cardioversion rate, time of birth process and neonatal Apgar score. Results Totally 283 cases delivery through vagina and 17 cases of cesarean section in observation group, while 257 cases of vaginal delivery and 43 cases of cesarean section in the control group.The successful rate of fetal position transfer in the observation group was 74.6% (211/283) which was significantly higher than 45.9% (118/257) of the control group (χ2=62.782, P<0.01), natural labor rate was also 87.3% (262/300) which increased significantly according to 64.7% (194/300) (χ2=42.251, P<0.01),the rate of midwifery (7.0%, 21/300) and cesarean section (5.7%, 17/300) were significantly lower than 21.0% (63/300)and 14.3% (43/300) of the control group (χ2=24.419, 12.519,P<0.01), the second stage of labor was (1.60±0.56) h which was significantly shortened than (2.19±0.53) h also(t=-12.589,P<0.01).In the observation group, the ratio of the posterior occipital position to the occipital transverse position after the opening of 8-10 cm and the complete dilation of the cervical were 7.4% (21/283) and 13.1% (37/283), which were also significantly increased than 3.4% (9/264), 6.8% (18/264) of the control group (χ2=4.240, 5.911, P<0.05). Conclusions Supine adjustment after the cervix dilatation larger than 5cm is more conducive to fetal rotation and to avoid the adverse complications, reduce the rate of vaginal delivery and cesarean section rate, improve the rate of natural childbirth, shorten delivery time, improve the quality of delivery. Key words: Labor analgesia; Supine adjustment; Posterior occipital position

The Collaborative IPD of Sleep and Stillbirth (Cribss): is maternal going-to-sleep position a risk factor for late stillbirth and does maternal sleep position interact with fetal vulnerability? An individual participant data meta-analysis study protocol

IntroductionAccumulating evidence has shown an association between maternal supine going-to-sleep position and stillbirth in late pregnancy. Advising women not to go-to-sleep on their back can potentially reduce late stillbirth rate...

Efficiency of the modified Sims maternal position in the rotation of persistent occiput posterior position during labor: A randomized clinical trial.

Fetal occiput posterior position in labor is associated with more painful and prolonged labor, and an increase in both maternal and fetal morbidity. The aim of this study is to assess whether the modified Sims position on the side of the fetal spine increases the rotation to occiput anterior position in women with epidural analgesia and a fetus in persistent occiput posterior (POP) position. This is an open, randomized controlled, clinical trial. One hundred and twenty women in labor with fetuses in POP position were included. The diagnosis was performed through digital vaginal examination and confirmed with an ultrasound scan. Women were randomized into the free position group or the modified Sims on the side of the fetal spine. The primary outcome was rotation to occiput anterior, and secondary outcomes were type of delivery, postpartum perineal condition, perinatal results, and maternal satisfaction. In pregnant women undergoing labor in the Sims position, fetuses in POP rotated to occiput anterior in 50.8% of cases, whilst in the free position group, the rotation occurred in 21.7% (P=.001). The rate of vaginal deliveries was higher in the Sims group compared with the free position group (84.7% vs 68.3%, P=.035). The modified Sims position is a maternal posture intervention efficient in POP rotation, which decreases cesarean delivery rate. It is a simple and noninvasive intervention, reproducible, and well tolerated by pregnant women.

Birth weight, gestational age and late adolescent liver function using twin status as instrumental variable in a Hong Kong Chinese birth cohort: “Children of 1997”

Birth weight (BW) is inversely associated with diabetes and liver function in Mendelian Randomization studies. Observationally, lower BW is usually also associated with poorer liver function. However, these studies could be confounded by socioeconomic position. Here we assessed if BW is associated with liver function in a unique population with little socio-economic patterning of BW, using both instrumental variable and an observational analysis.We used instrumental variable analysis (IVA) to assess the association of BW with liver function (alanine transaminase (ALT), alkaline phosphatase (ALP), bilirubin, and albumin) at ~17 years with twin status as an instrumental variable in the prospective population-representative “Children of 1997” birth cohort (n = 8327). We also conducted an observational analysis adjusted for sex, maternal age, maternal migrant status, smoking and parental socio-economic position. A generalized linear model with gamma family was used for ALT, ALP, and bilirubin because they are not normally distributed.Using IVA, BW was not associated with ALT, ALP or bilirubin, but was possibly negatively associated with albumin (−1.12 g/L, 95% confidence interval (CI) −2.08 to −0.16). Observationally, BW was negatively associated with ALT (−1.23 IU/L, 95% CI −2.16 to −0.30), ALP (−1.72 IU/L, 95% CI −3.43 to −0.01) and higher albumin (−0.23 g/L, 95% CI −0.40 to −0.06).Poor liver function may be a pathway by which the risks of lower BW are actuated. This insight might help identify post-natal targets of intervention to mitigate the adverse health effects of lower birth weight.

Upright Versus Lying Down Position in Second Stage of Labour in Nulliparous Women With Low Dose Epidural: BUMPES Randomised Controlled Trial

(Abstracted from BMJ 2017;359:j4471) Epidural analgesia is the most effective and preferred form of pain relief in labor; however, it can lead to the prolongation of the second stage of labor and also increase the risk of instrumental vaginal delivery. Maternal position during the second stage of labor could also affect the risk of instrumental vaginal delivery.

Knowledge, attitude, and perception regarding breastfeeding practices among mothers of Indore city: A cross-sectional study

Introduction: Breast milk is planned for nursing young ones and therefore considered as nature’s most precious gift to humankind. However, despite strong evidences in support of breastfeeding, its prevalence has remained low worldwide. Objective: The objective of this study is to explore the knowledge, attitude, and perception toward breastfeeding among primigravida mothers and factors determining them. Materials and Methods: The study was conducted over 18 months on primigravida mothers admitted in postnatal care ward of tertiary care center of a medical college. Questionnaires were filled by mothers of newborns about various domains such as initiation of feeding, latching, maternal position during breastfeeding, prelacteal, colostrum, exclusive breastfeeding (EBF), and feeding at public places. Results: A total of 260 women aged 21–25 years were included in the study. Most of them were the housewives (81.5%), Hindu (95.4%), living in joint family (55.8%), and living in urban area (73.8%). About 90.4% initiated breastfeeding immediately after delivery and mothers have good knowledge on breastfeeding (81.1%). Mothers living in joint family had significantly more knowledge about the EBF and importance of colostrum. The source of their knowledge regarding breastfeeding was mostly medical staff (95.4%). Conclusion: The present study found that mothers had satisfactory knowledge regarding breastfeeding. Proper counseling and all level of support should be given to primigravida mothers, and breastfeeding practices can be increased by strengthening the existing program through media support and by removing social taboo regarding breastfeeding.

459: Sonographically measured inferior vena caval diameter in response to different maternal positions in pregnancy

Placing pregnant patients in left lateral tilt (LLT) position to avoid compression of the inferior vena cava (IVC) has long been standard obstetric practice. The American Heart Association recommends continuous manual left uterine displacement (LUD) instead of LLT position during a maternal cardiac arrest. The relationship between maternal position and proximal filling of the IVC is unknown. The hypothesis is that the maternal IVC diameter would increase in response to LLT and LUD compared to supine position. A pilot prospective observational study was performed on 60 healthy gravidas. 30 patients at 20-24 weeks and 30 patients at 37-41 weeks were recruited. Patients were placed in supine, 30 degree left lateral tilt and supine with left uterine displacement positions. The IVC was visualized by ultrasound using the subxiphoid technique. The primary outcome was IVC diameter at end expiration. Descriptive analysis and student's paired t-test were performed. In the 20-24 weeks cohort, patients in LLT position (77.5 +/- 9.8, p=0.03) and LUD position (77.3 +/-9.5, p=0.04) had a significant decrease in heart rate (bpm) compared to supine position (80.5 +/-8.5). Patients in the LUD position (80.7 +/-7.6, p<0.001) had a significant decrease in MAP compared to supine position (83.7 +/- 7.4). No significant differences were seen in the IVC diameter between all 3 positions.In the 37-41 weeks cohort, there were no significant differences in the MAP, heart rate, and IVC measurement between all 3 positions.In the 20-24 weeks cohort, 48.3%, 30%, 18.3% of patients had their largest IVC diameter in the LUD, LLT, and supine position, respectively. In the 37-41 weeks cohort, 33.3%, 28.3%, 30% of patients had their largest IVC diameter in the LUD, LLT, and supine position, respectively. 1 subject in each cohort experienced symptoms consistent with supine hypotension syndrome in the supine position (3.33%). Sonographically the IVC diameters were not statistically different between all 3 positions. Furthermore, 18% in the 20-24 weeks cohort and 30% in the 37-41 weeks cohort had their largest IVC diameter in the supine position. This observation challenges the universal belief of uterine IVC compression with associating decrease in proximal IVC filling among pregnant cohort. This study suggests that LLT or LUD may not be universally beneficial.

The Effect of Different Maternal Positions on Reactivity of the Nonstress Test, Maternal Blood Pressure and Heart Rate

The Effect of Different Maternal Positions on Reactivity of the Nonstress Test, Maternal Blood Pressure and Heart Rate

The effect of maternal position on foetal middle cerebral to umbilical artery resistance index ratio

The effect of maternal position on foetal middle cerebral to umbilical artery resistance index ratio

PEMIKIRAN TAQIYUDDIN AN- NABHANI TENTANG PENGATURAN INTERAKSI PRIA DAN WANITA

Taqiyuddin an-Nabhani, in his work, the display settings for the social interaction of men and women. Therefore, setting the interactions of men and women with respect to employment should be examined thoroughly and deeply. An-Nabhani Taqiyuddin work is built on a number of basic views, namely: the first is changed views about men and women. Islam sees that the Almighty God created human beings, both men and women are provided with the same nature, the presence of physical needs and the same instincts, also has the potential to be equally sensible. Both are obliged to pray, fast, filial to parents, preach Islam. Both views about the legal status of male and female relationships, meetings of men and women within the framework of cooperation in the midst of life, such as in trade, education, political and ijarah. It is of necessity to realize the benefit of both of them and society in General. Therefore, the meeting and interaction should be done with the basic views and cooperation arrangements that gave birth to virtue for society and individuals, ensuring the realization of the lofty values and means God Almighty. The third position of men and women in the presence of taklif syara '. Islamic jurisprudence imposes a taklif on humans regardless of sex. The emerging issues related to the nature of kemaskulinan or kefemininan, the Sharia law in accordance with the taklif bring nature of it. For example, jurisprudence and the law about taklif bring position, fatherly roles and responsibilities only to men while the maternal position relating to only to women.