Effect of Different Fetal Spine Positions During Early Labour on Maternal Comfort and Birth Outcomes

Abstract

Abstract Background This study aimed to determine the maternal preferred lateralization position at the latent phase and the effect of maternal lateralization-fetal spine concordance during the active phase of the first stage of labor on maternal comfort. Methods This prospective cohort study involved pregnant women, who attended to labor room at Hospital Raja Perempuan Zainab II with singleton pregnancies in the first stage of labor at 37 weeks of gestation and beyond. They were recruited after fulfilling the criteria selection. Fetal occiput and spine position was confirmed by transabdominal ultrasound examination, and the maternal preference position at the latent phase of the first stage of labor was identified. Participants were randomly assigned to one of two maternal position groups: same lateralization with the fetal spine (n = 180) and opposite to the fetal spine (n = 180). The maternal mean comfort score was assessed during the first stage of labor. Secondary outcome measures (labor duration, pain relief, cardiotocography (CTG) reactivity, and fetal condition at birth) were recorded. The results were analyzed using descriptive statistics, chi-square test (categorical variables), and t-test (numerical variables to evaluate differences while kappa statistics to show agreement between groups) Results The preferred maternal position at the latent phase of labor was associated with the same maternal lateralization-fetal spine concordance (p < 0.001). Higher means comfort score in the same lateral position of the mother and fetal spine during the active phase of the first stage of labor but the difference is not significant. A significant association between maternal position and fetal well-being based on cardiotocography (CTG) tracing with the same position having more cases of normal CTG tracing. Duration of labor, mode of delivery, the requirement of analgesia, and Apgar score were not associated with lateralization of the mother and fetal spine position during labor. Conclusion Parturients preferred lying in concordant with the fetal spine lateralization position at the latent phase of the first stage of labor and they were also more comfortable in that position during the active phase of labor with reassuring fetal well-being on CTG tracing.