Effect of maternal position during labor and delivery on maternal acid-base balance and condition of newborn

2.50
Hdl Handle:
http://hdl.handle.net/10755/154690
Type:
Presentation
Title:
Effect of maternal position during labor and delivery on maternal acid-base balance and condition of newborn
Abstract:
Effect of maternal position during labor and delivery on maternal acid-base balance and condition of newborn
Conference Sponsor:Sigma Theta Tau International
Conference Year:1989
Author:Liu, Yuen, PhD
Title:Retired
Labor and delivery are times of dynamic change when the mother tends to develop a state of metabolic acidosis, the etiology for this is not entirely clear. The main metabolite is lactic acid. Studies suggest hyperventilation, starvation, skeletal muscle activity, uterine contraction, endogenous catechdamine production, and muscular effort associated with bearing down as the etiologic factor. Parity, labor duration, and maternal position greatly influence the status of acid-base balance.



The upright position is advantageous in reducing labor and delivery time. Yet, little information exists concerning its effect on the acid-base balance, particularly without medication and operative intervention.



The studys objective was to compare effects of maternal positions during parturition on acid-base balance. Hypotheses were: shorter labor for primigravidae delivering in 30 degree upright positions compared to those delivering in zero degree recumbent positions; lower acid-base fluctuation among the upright position; and lower acid-based balance fluctuation in the umbilical cord blood of newborns of upright position mothers.



Participation consent was obtained from 60 married primigravidae, 40 in the upright and 20 in the recumbent position. Nursing care was identical except beds used in the upright group were rotated through a 30 degree arc. No medication or oxygen therapy was administered.

Labor duration was analyzed using one-way analysis of variance. The first state duration mean was 66.48 minutes shorter (P<.039) and second stage mean was 35.54 minutes shorter (P<0,0001) for the upright position. Using analysis of covariance to analyze maternal pH, pCo2, HCo3, and lactic acid, difference between groups mean for pH was 0.05 at 10 cm cervical dilatation and 0.24 immediately after delivery. Although there was no statistical significance at 0.05 level, since “normal” blood pH range is from 7.36 – 7.44 with 0.08 in its fluctuation, a difference of 0.24 requires clinical attention.

Significant lesser disturbance among the upright position was shown for pCo2. Mean pCo2 levels difference was 4.95 mmHg (P<.001) for 10 cm dilatation and 3.47 mmHg (P<.05) immediately after delivery. HCo3 difference at 10 cm dilatation was 1.27 mEq/L (P<.05) and 0.78 mEq/L levels as labor increased. Contrasting with greater pH, pCo2, and HCo3 fluctuation among the recumbent position, lactic acid level change was higher in the upright position. Mean difference was 0.37 mmol/L (P<0.001) at 10 cm dilatation and 0.04 mmol/L (P<0.001) after delivery. Slight differences indicating no statistical significance among the groups were observed in the infants umbilical cord blood pH, pCo2, and HCo3. Mean score difference was 0.01 (P<.941) for pH; 1.83 mmHg (P<.419) for pCo2, and 0.72 mEq/L (P<.731) for HCo3.



The study confirms the upright position reduced labor and delivery duration with lesser degree of fluctuation in acid-based balance among mothers in the upright position. Newborns condition remained within normal range with no difference in the umbilical cord blood acid-base balance among the two groups.



The knowledge concerning the phenomena of human birth is essential to safe and effective obstetric nursing in order to safeguard the health and well-being of both mother and newborn.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEffect of maternal position during labor and delivery on maternal acid-base balance and condition of newbornen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154690-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Effect of maternal position during labor and delivery on maternal acid-base balance and condition of newborn</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1989</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Liu, Yuen, PhD</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Retired</td></tr><tr><td colspan="2" class="item-abstract">Labor and delivery are times of dynamic change when the mother tends to develop a state of metabolic acidosis, the etiology for this is not entirely clear. The main metabolite is lactic acid. Studies suggest hyperventilation, starvation, skeletal muscle activity, uterine contraction, endogenous catechdamine production, and muscular effort associated with bearing down as the etiologic factor. Parity, labor duration, and maternal position greatly influence the status of acid-base balance.<br/><br/><br/><br/>The upright position is advantageous in reducing labor and delivery time. Yet, little information exists concerning its effect on the acid-base balance, particularly without medication and operative intervention.<br/><br/><br/><br/>The studys objective was to compare effects of maternal positions during parturition on acid-base balance. Hypotheses were: shorter labor for primigravidae delivering in 30 degree upright positions compared to those delivering in zero degree recumbent positions; lower acid-base fluctuation among the upright position; and lower acid-based balance fluctuation in the umbilical cord blood of newborns of upright position mothers.<br/><br/><br/><br/>Participation consent was obtained from 60 married primigravidae, 40 in the upright and 20 in the recumbent position. Nursing care was identical except beds used in the upright group were rotated through a 30 degree arc. No medication or oxygen therapy was administered.<br/><br/>Labor duration was analyzed using one-way analysis of variance. The first state duration mean was 66.48 minutes shorter (P&lt;.039) and second stage mean was 35.54 minutes shorter (P&lt;0,0001) for the upright position. Using analysis of covariance to analyze maternal pH, pCo2, HCo3, and lactic acid, difference between groups mean for pH was 0.05 at 10 cm cervical dilatation and 0.24 immediately after delivery. Although there was no statistical significance at 0.05 level, since &ldquo;normal&rdquo; blood pH range is from 7.36 &ndash; 7.44 with 0.08 in its fluctuation, a difference of 0.24 requires clinical attention.<br/><br/>Significant lesser disturbance among the upright position was shown for pCo2. Mean pCo2 levels difference was 4.95 mmHg (P&lt;.001) for 10 cm dilatation and 3.47 mmHg (P&lt;.05) immediately after delivery. HCo3 difference at 10 cm dilatation was 1.27 mEq/L (P&lt;.05) and 0.78 mEq/L levels as labor increased. Contrasting with greater pH, pCo2, and HCo3 fluctuation among the recumbent position, lactic acid level change was higher in the upright position. Mean difference was 0.37 mmol/L (P&lt;0.001) at 10 cm dilatation and 0.04 mmol/L (P&lt;0.001) after delivery. Slight differences indicating no statistical significance among the groups were observed in the infants umbilical cord blood pH, pCo2, and HCo3. Mean score difference was 0.01 (P&lt;.941) for pH; 1.83 mmHg (P&lt;.419) for pCo2, and 0.72 mEq/L (P&lt;.731) for HCo3.<br/><br/><br/><br/>The study confirms the upright position reduced labor and delivery duration with lesser degree of fluctuation in acid-based balance among mothers in the upright position. Newborns condition remained within normal range with no difference in the umbilical cord blood acid-base balance among the two groups.<br/><br/><br/><br/>The knowledge concerning the phenomena of human birth is essential to safe and effective obstetric nursing in order to safeguard the health and well-being of both mother and newborn.</td></tr></table>en_GB
dc.date.available2011-10-26T13:11:59Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T13:11:59Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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