うつ病と不安に関するジャーナル
オープンアクセス

概要

New Delivery Chair for Vaginal Delivery

Vedran Stefanovic, Veli-Matti Ulander, Mervi Vaisanen-Tommiska, Sanna Suomalainen-Konig, Eija Kortelainen, Christina Salmen, Minna Tikkanen and Jorma Paavonen*

Objectives: Compared to different upright positions, delivery in recumbent position in bed may increase the likelihood of operative delivery and other delivery complications, and also decrease levels of maternal self-control. A new delivery chair has been developed to facilitate a variety of upright positions during labour. A randomized controlled trial was conducted to evaluate the impact of the delivery chair use on selected obstetrical and neonatal outcomes, compared to traditional recumbent position.

Methods: A total of 1477 women with uncomplicated singleton pregnancy ≥ 34 gestational weeks with fetus in vertex presentation were enrolled in the study: 776 in the delivery chair group, and 701 in the control group.

Results: An intention-to-treat analysis showed no differences between the groups in any of the outcomes used. Of the women in the delivery chair group, 251 used the chair throughout the second stage. An as-treated analysis was performed between these 251 women and their counterparts in the control group. Women using the delivery chair had a shorter second stage of delivery, fewer episiotomies, and less need for vacuum extraction, with no difference in blood loss or neonatal outcome. However, women using the delivery chair had more third-degree tears (11 cases, or 4.4%, vs. 9 cases, or 1.8%).

Conclusion: The novel delivery chair can be safely used for vaginal delivery. More attention should be given to perineal support to prevent perineal tears. There is a need for multicentre trials of the delivery chair using standardized measurements of outcomes, including maternal pain, maternal self-control, and overall satisfaction.