Satisfacción materna en el ensayo clínico �Eficacia de la postura materna en partos con malposición fetal occipitoposterior�

Resumo

clinical trial about the efficacy of the hands-knees (HK) and lateral decubitus (LD) postures towards the fetal back in order to achieve the rotation of the fetus. Secondarily, the influence of satisfaction regarding care received during labor was also assessed, as well as obstetric factors and mother-fetus outcomes. Materials and methods: multicenter clinical trial with pregnant ­women with fetal occiput posterior position, which adopted the hands-knees (HK) posture in one group, and the lateral decubitus (LD) posture in the other group. Variables: maternal satisfaction (measured with the adapted COMFORTS scale), parity, fetal rotation to occiput anterior, epidural analgesia, type of labor and Apgar Test. A multivariate logistic regression analysis was conducted. Results: thirty-eight women in the HK group and forty-seven in the DL took part in the study. Abdominal or perineal lesion obtained the lowest satisfaction score (mean: 4.31 over 5; 49.4% of very satisfied women); the encouragement of mother-child bonding obtained the highest score (mean: 4.92 of 5; 91.8% of very satisfied women). The satisfactory experience of labor was higher in the HK group (92.1% vs. 87.2%), with Odds Ratio (OR) adjusted to obstetric variables of 5.18 (Confidence Interval (IC) at 95%: 1.08-24.82); higher satisfaction with Apgar Test at 1 minute >8 vs. = 8 (90.4% vs. 83.3%), (OR= 5.26; IC95%:1.68-16.51). Conclusions: maternal satisfaction was very high, but the satisfactory labor experience was higher in those women who adopted the HK position. This experience is influenced by the care provided by the midwife and the obstetric results, particularly by the health status of the baby.