[Comparison of obstetric and perinatal results of childbirth vertical position vs. childbirth supine position]. / Comparación de resultados obstétricos y perinatales del parto en postura vertical versus supina.

BACKGROUND: Vertical position is an option to delivery to which several advantages have been attributed. This research exposes its related findings. OBJECTIVE: To compare obstetric and perinatal outcomes between supine and vertical position at delivery. PATIENTS AND METHOD: We performed a randomized double-blind study including healthy women assigned to the supine or upright posture (vertical) during labor with complications following the delivery in the puerperium stage. The variables evaluated were: blood loss, pain in the second period of labor and immediate postpartum, duration of the second period of labor, perineal and vaginal tears, need to forceps implement, accommodation in position and perinatal outcome. RESULTS: 164 patients were randomized into two groups, the vertical position (I) and the supine position (II). The losses were 5.4%, and the Caesarean rate was of 4.6%. Difference was found only for vaginal tears in the vertical posture, with a relative risk of 1.4 (CI 1.1-3.2), and shortening of the second period with a significant difference of 10 minutes on average (p < 0.05). CONCLUSIONS: The upright posture during childbirth provides no improvement in perinatal outcomes and fewer obstetric conditions. It shortens the second period of labor, but it is a risk factor for vaginal tears. The best position for birth is which offers more comfort to the patient.

[Extreme maternal morbidity in the Hospital General Dr. Aurelio Valdivieso, Oaxaca Health Services]. / Morbilidad materna extrema en el Hospital General Dr. Aurelio Valdivieso, Servicios de Salud de Oaxaca.

BACKGROUND: Obstetric Morbidity Extreme (OME) is a promising addition to the investigation of maternal deaths and is used for the evaluation and improvement of maternal health services is defined as a severe obstetric complication that threatens the life of the pregnant woman and requires urgent medical intervention to prevent death of the mother. OBJECTIVE: To identify association between diseases and obstetric morbidity Extreme. MATERIAL AND METHOD: Transversal review analytical records. We searched for codes related to conditions that could cause extreme obstetric morbidity and the indirect causes that might cause it. RESULTS: The prevalence of OME 21 per 1000 newborns, diseases with greater association were eclampsia, liver failure and preeclampsia yielded the highest OR and statistical significance, the association of OME derived from surgery despite having a high prevalence in the analysis showed no association, in the same way if other variables showed association but had no significance and confidence intervals are below the unit that is the case of renal failure, metabolic failure and blood transfusion. CONCLUSIONS: The OME is caused by group entities specific disease (FLASOG) in most cases such as preeclampsia, eclampsia and obstetric hemorrhage.