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The association between fetal position at the onset of labour and birth outcomes

Ahmad, Aishah (2012)
Ph.D. thesis, University of Birmingham.

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Fetal position throughout labour exerts considerable influence on labour and delivery, with a mal-positioned fetus during active labour known to contribute towards fetal and maternal morbidity. In response there is a move towards promoting the Left Occipito-Anterior (LOA) position at labour onset as optimal. It is thought that the LOA position encourages anterior rotation thus reducing the likelihood of mal-rotation.
A systematic review was undertaken which highlighted an absence of scientific evidence. A prospective cohort study was therefore conducted with 1250 nulliparous women who were scanned to accurately determine fetal position, specifically the LOA position at the onset of labour and the association with delivery mode and other birth outcomes was examined.
The LOA position at the onset of labour was not associated with mode of delivery, nor were any of the other positions (p=0.39). Pain relief, labour duration, augmentation, and Apgar scores did not show any association with the LOA or other positions. The only association found was that women with a fetus in the posterior position were more likely to use pethidine (p=0.008).
This study has shown that the LOA fetal position at labour onset was not associated with improved outcomes and therefore should not be promoted as optimum

Type of Work:Ph.D. thesis.
Supervisor(s):MacArthur, Christine and Khan, Khalid and Winter, Heather
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:Department of Public Health and Epidemiology
Subjects:RG Gynecology and obstetrics
Institution:University of Birmingham
ID Code:3723
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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