Vacuum-assisted birth in maternal lateral posture versus lithotomy. A simulation study

Eur J Obstet Gynecol Reprod Biol. 2023 Nov:290:88-92. doi: 10.1016/j.ejogrb.2023.09.017. Epub 2023 Sep 20.

Abstract

Objective: Maternal lateral postures provide advantages during childbirth. This study aims to investigate the feasibility of assisting vacuum births in maternal lateral postures in a simulation model.

Study design: In a simulation model, four obstetricians and four medical students were randomly allocated to perform vacuum-assisted births first in maternal lateral posture or lithotomy. A modification of Aldo Vacca's 5-step technique was developed to assist vacuum-assisted births in lateral posture. The lateral distance, vertical distance, and distance from the cup center to the flexion point were measured for every placement of the cup.

Results and conclusions: A total of 128 vacuum-assisted births were performed. The mean distance to the flexion point was 1.15 ± 0.71 cm for the lithotomy posture and 1.31 ± 0.82 cm for the lateral posture (P = 0.127). There were no statistically significant differences in vacuum extractor cup placement accuracy based on maternal posture. Performing vacuum-assisted births in maternal lateral posture is feasible in a simulation model. The technique is easy to learn, and the differences in cup placement between the lateral and lithotomy postures are small.

Keywords: Childbirth; Labor; Lateral posture; Maternal position; Simulation; Vacuum.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Computer Simulation
  • Delivery, Obstetric* / methods
  • Female
  • Humans
  • Posture*
  • Pregnancy
  • Vacuum Extraction, Obstetrical