Child birth; comparison of complications between lithotomy position and squatting position during

ABSTRACT

The purpose of the study was to compare the complications of delivery in squatting and lithotomy position of mother. Randomized controlled trial. Gynecology/Obstetrics Unit-II, Sandeman Provincial Teaching Hospital, Quetta. 6 months [05 Oct, 2011 to 05 April, 2012]. Hundred and fifty one patients with lithotomy position in delivery were compared with hundred and fifty one patients with squatting position in delivery regarding risks of perineal tears, periurethral tear, extended episiotomy, instrumental delivery, caesarean section and primary postpartum hemorrhage. Data was recorded on a specially designed Performa and was analyzed by using SPSS.V. 10. Results were compared using Chi-square test by keeping the p-value of < 0.05 as significant. 151 patients in lithotomy position and 151 patients in squatting position were compared and studied for complications during delivery. Extension of the episiotomy was observed in [7%] of non-squatting groups. There were no extensions of episiotomy in squatting group. There were no second degree, or third degree perineal tears in squatting group which were encountered in [9%] patients in the lithotomy position group [P<0.05]. Forceps application was also less in squatting position group 11% patients, whereas 24% patients were delivered by forceps in lithotomy group, [P<0.05]. One patient in the lithotomy position had to have a caesarean section due to persistent occipito-posterior position. There was no case of retained placenta or postpartum hemorrhage in squatting group whereas there were 4% cases of retained placenta and 1 case of postpartum hemorrhage due to atony of the uterus in lithotomy position group. It appears that the routine use of lithotomy position may have some disadvantages in terms of more instrumental deliveries and episiotomies. Moreover women experience significant pain in this position. It is suggested that more trials should be conducted and the position at the moment of birth should be registered to measure its influence on birth outcome: