Effect of Maternal Semi Sitting Versus Dorsal Recumbent Position during the Second Stage of Labor on Maternal, Fetal and Neonatal Outcome

Position affects the woman's anatomic and physiological adaptation to labor. For the second stage of labor an ideal position would open the pelvic outlet as widely as possible, provide a smooth path for the baby to descend through the birth canal, use the advantages of gravity to help the baby move down and give the mother a sense of the process. A Quasi experimental design was used in carrying out this study that aimed to assess the effect of maternal semi-sitting versus dorsal recumbent position on labor outcomes. It was carried out at the delivery unit of IsmailiaUniversityHospital. A representative sample of 200 women was recruited for this study according to certain criteria. The study subjects were equally divided into two equal groups, group I who assumed the semi-sitting position and group II who assumed the dorsal recumbent position. Data were collected through a structured interviewing schedule, and an observation checklist that were developed, validated and used to collect the necessary data. . The results revealed that group II had lower B.P (35.0%) compared to group I (3.0%). uterine contractions with an interval of 2 min., longer duration (>70-90 sec.) and severe intensity were significantly higher (89.0%, 93.0% and 95.0%) of group I respectively. Moreover, women they were more likely to push effectively (92.0%) of group I than group II (73.0%). Fetal heart rate below normal (15.0%) of group II   compared to(3.0%)of group I .Spontaneous rupture of membrane was also higher (83.0%) among group I  compared to (81.0%) of group II .  Women in the group I had higher percentage of normal delivery (53.0%), and low percentage of episiotomy (25.0%) and perineal tear (22.0%) compared to group II (25.0%, 30.0% and 45.0% respectively). The mean duration of 2^nd stage of labor was statistically higher (48.2±10.0) among group II than group I (42.3±8.5). Also mean neonatal Apgar score a statistically significant at first and fifth minutes among group I than group II. It is concluded that semi-sitting position had a significant effect on the improvement of labor outcomes. Thus it is recommended that birth attendant should be advised to deliver woman while she is in semi-sitting position instead of routine use of dorsal recumbent position during the second stage of labor.