Abstract:
BACKGROUND:For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting) or lying down have advantages for women delivering their babies. OBJECTIVES:To assess the benefits and risks of the use of different positions during the second stage of labour (i.e. from full dilatation of the cervix). SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group trials register (16 April 2003). SELECTION CRITERIA:Trials that used randomised or quasi-randomised allocation and appropriate follow up and compared various positions assumed by pregnant women during the second stage of labour. DATA COLLECTION AND ANALYSIS:We independently assessed the trials for inclusion and extracted the data. MAIN RESULTS:Results should be interpreted with caution as the methodological quality of the 19 included trials (5764 participants) was variable. Use of any upright or lateral position, compared with supine or lithotomy positions, was associated with: reduced duration of second stage of labour (10 trials: mean 4.29 minutes, 95% confidence interval (CI) 2.95 to 5.64 minutes) - this was largely due to a considerable reduction in women allocated to the use of the birth cushion; a small reduction in assisted deliveries (18 trials: relative risk (RR) 0.84, 95% CI 0.73 to 0.98); a reduction in episiotomies (12 trials: RR 0.84, 95% CI 0.79 to 0.91); an increase in second degree perineal tears (11 trials: RR 1.23, 95% CI 1.09 to 1.39); increased estimated blood loss greater than 500 ml (11 trials: RR 1.68, 95% CI 1.32 to 2.15); reduced reporting of severe pain during second stage of labour (1 trial: RR 0.73, 95% CI 0.60 to 0.90); fewer abnormal fetal heart rate patterns (1 trial: RR 0.31, 95% CI 0.08 to 0.98). REVIEWER'S CONCLUSIONS:The tentative findings of this review suggest several possible benefits for upright posture, with the possibility of increased risk of blood loss greater than 500 ml. Women should be encouraged to give birth in the position they find most comfortable. Until such time as the benefits and risks of various delivery positions are estimated with greater certainty, when methodologically stringent trials' data are available, women should be allowed to make informed choices about the birth positions in which they might wish to assume for delivery of their babies.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Gupta JK,Hofmeyr GJdoi
10.1002/14651858.CD002006.pub2keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
CD002006issue
1issn
1469-493Xpub_type
杂志文章,评审abstract:BACKGROUND:The partogram (sometimes known as partograph) is usually a pre-printed paper form on which labour observations are recorded. The aim of the partogram is to provide a pictorial overview of labour, to alert midwives and obstetricians to deviations in maternal or fetal wellbeing and labour progress. Charts ofte...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005461.pub3
更新日期:2012-08-15 00:00:00
abstract:BACKGROUND:Heel lance has been the conventional method of blood sampling in neonates for screening tests. Neonates undergoing this procedure experience pain. Despite various studies evaluating the role of pharmacological and non-pharmacological interventions to date, there are no effective and practical methods to alle...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001452
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:The use of prophylactic antibiotics to reduce the frequency and severity of acute exacerbations of chronic bronchitis is controversial. OBJECTIVES:To determine if prophylactic antibiotics reduce the frequency of exacerbations and/or days of disability in subjects with chronic bronchitis. SEARCH STRATEGY:We...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004105
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Nystatin is sometimes used prophylactically in patients with severe immunodeficiency or in the treatment of fungal infection in such patients, although its effect seems to be equivocal. OBJECTIVES:To study whether nystatin decreases morbidity and mortality when given prophylactically or therapeutically to p...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002033.pub2
更新日期:2014-09-04 00:00:00
abstract:BACKGROUND:Therapeutic exercise is used as one modality to treat people with osteoarthritis (OA). OBJECTIVES:To evaluate the effectiveness of therapeutic exercise of differing intensities on objective and subjective measures of disease activity in people with OA. SEARCH METHODS:We searched MEDLINE, EMBASE, Pedro, Cur...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD004259.pub2
更新日期:2013-02-28 00:00:00
abstract:BACKGROUND:Several agents are used to clear secretions from the airways of people with cystic fibrosis. Mannitol increases mucociliary clearance, but its exact mechanism of action is unknown. The dry powder formulation of mannitol may be more convenient and easier to use compared with established agents which require d...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008649.pub3
更新日期:2018-02-09 00:00:00
abstract:BACKGROUND:Cognitive behavioural therapy (CBT) is now a recommended treatment for people with schizophrenia. This approach helps to link the person's feelings and patterns of thinking which underpin distress. OBJECTIVES:To review the effects of CBT for people with schizophrenia when compared to standard care, specific...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000524.pub2
更新日期:2004-10-18 00:00:00
abstract:OBJECTIVES:To determine whether antidepressants are clinically effective and acceptable for the treatment of depression in people who also have a physical illness. SEARCH STRATEGY:Medline, Cochrane Library Trials Register and Cochrane Depression and Neurosis Group Trials Register were all systematically searched, supp...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001312
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. OBJECTIVES:The objective of this review was t...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004476.pub3
更新日期:2018-03-13 00:00:00
abstract:BACKGROUND:Respiratory distress syndrome is a serious complication of prematurity causing significant immediate and long-term mortality and morbidity. OBJECTIVES:The objective of this review was to assess the effects of corticosteroids administered to pregnant women to accelerate fetal lung maturity prior to preterm d...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000065
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder of unknown aetiology. Current pharmacological treatments have limited value. Hypnotherapy has been reported to have beneficial effects for IBS symptoms. OBJECTIVES:To evaluate the efficacy of hypnotherapy for the treatment of ir...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005110.pub2
更新日期:2007-10-17 00:00:00
abstract:BACKGROUND:Physiological monitoring studies indicate that some preterm infants experience episodes of oxygen desaturation, apnoea, or bradycardia when seated in standard car safety seats. The American Academy of Pediatrics recommends that all preterm infants should be assessed for cardiorespiratory stability in their c...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005386.pub2
更新日期:2006-01-25 00:00:00
abstract:BACKGROUND:Occupational exposure to hazardous drugs can decrease fertility and result in miscarriages, stillbirths, and cancers in healthcare staff. Several recommended practices aim to reduce this exposure, including protective clothing, gloves, and biological safety cabinets ('safe handling'). There is significant un...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD012860.pub2
更新日期:2018-03-27 00:00:00
abstract:BACKGROUND:The common cold is considered to be caused by viruses and it has long been believed that antibiotics have no role in treating this condition. In many countries doctors will often prescribe antibiotics for the common cold in the belief that they may prevent secondary bacterial infection and in some cases to r...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000247
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Antibodies against hepatitis B surface antigen (HBsAg) wane over time following hepatitis B immunisation; hence, it is unclear whether people vaccinated in three-dose or four-dose schedules of the hepatitis B vaccine are still immune when the hepatitis B surface antibody (anti-HBs) level in their body is und...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD008256.pub3
更新日期:2016-06-07 00:00:00
abstract:BACKGROUND:Cervical priming before first-trimester surgical abortion is recommended in certain groups of women. Nitric oxide (NO) donors induce cervical ripening without uterine contractions, but the efficacy and side effects are of concern. OBJECTIVES:To evaluate efficacy, side effects and complications of NO donors ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD007444.pub2
更新日期:2009-10-07 00:00:00
abstract:BACKGROUND:In pregnancies complicated by diabetes the major concerns during the third trimester are fetal distress and the potential for birth trauma associated with fetal macrosomia. OBJECTIVES:The objective of this review was to assess the effect of a policy of elective delivery, as compared to expectant management,...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001997
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Endovascular stents have been suggested as a means to improve the patency of arteries after angioplasty in patients with intermittent claudication. This is an update of a Cochrane review published in 2002. OBJECTIVES:The null hypothesis to be tested by this review is that for individuals with claudication t...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD003228.pub2
更新日期:2010-01-20 00:00:00
abstract:BACKGROUND:The most common psychiatric diagnosis among cancer patients is depression; this diagnosis is even more common among patients with advanced cancer. Psychotherapy is a patient-preferred and promising strategy for treating depression among cancer patients. Several systematic reviews have investigated the effect...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD005537.pub3
更新日期:2018-11-22 00:00:00
abstract:BACKGROUND:Use of a central venous catheter (CVC) in neonates is associated with an increase in nosocomial infection. Numerous strategies exist to prevent catheter-related bloodstream infection (CRBSI); however, CRBSI continues to be a major problem. Antibiotic locking catheters is a new and promising treatment that po...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD010336.pub2
更新日期:2015-06-04 00:00:00
abstract:BACKGROUND:Multifocal motor neuropathy is characterised by progressive, predominantly distal, asymmetrical limb weakness and usually multiple partial motor nerve conduction blocks. Intravenous immunoglobulin is beneficial but the role of immunosuppressive agents is uncertain. This is an update of a review first publish...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003217.pub4
更新日期:2012-04-18 00:00:00
abstract:BACKGROUND:Respiratory syncytial virus infection causes acute lung infection in infants and young children worldwide, resulting in considerable morbidity and mortality. Children with cystic fibrosis are prone to recurrent lung inflammation, bacterial colonisation and subsequent chronic airway disease, putting them at r...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD007743.pub6
更新日期:2016-07-20 00:00:00
abstract:BACKGROUND:Acute bacterial meningitis remains a disease with high mortality and morbidity rates. However, with prompt and adequate antimicrobial and supportive treatment, the chances for survival have improved, especially in infants and children. Careful management of fluid and electrolyte balance is an important suppo...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004786.pub3
更新日期:2008-01-23 00:00:00
abstract:BACKGROUND:Traumatic dental injuries are common. One of the most severe injuries is when a permanent tooth is knocked completely out of the mouth (avulsed). In most circumstances the tooth should be replanted as quickly as possible. There is uncertainty on which interventions will maximise the survival and repair of th...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD006542.pub3
更新日期:2019-02-05 00:00:00
abstract:BACKGROUND:Rotavirus results in more diarrhoea-related deaths in children less than five years of age than any other single agent in countries with high childhood mortality. It is also a common cause of diarrhoea-related hospital admissions in countries with low childhood mortality. Currently licensed rotavirus vaccine...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008521.pub3
更新日期:2012-11-14 00:00:00
abstract:BACKGROUND:Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated w...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008040.pub2
更新日期:2010-11-10 00:00:00
abstract:BACKGROUND:Mefloquine is a commonly prescribed antimalarial drug which has now largely replaced earlier malaria chemoprophylaxis, since increasing parasite resistance has meant that these earlier drugs are no longer considered to be effective against all Plasmodium species. However mefloquine may be associated with neu...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000138
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Methotrexate (MTX) is among the most effective disease modifying anti-rheumatic drugs (DMARDs) in rheumatoid arthritis (RA) with less toxicity and better tolerability. OBJECTIVES:To evaluate the efficacy and toxicity of MTX monotherapy compared to MTX combination with non-biologic DMARDs in adult with RA. ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008495
更新日期:2010-04-14 00:00:00
abstract:BACKGROUND:Post-extraction bleeding (PEB) is a recognised, frequently encountered complication in dental practice, which is defined as bleeding that continues beyond 8 to 12 hours after dental extraction. The incidence of post-extraction bleeding varies from 0% to 26%. If post-extraction bleeding is not managed, compli...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD011930.pub2
更新日期:2016-06-10 00:00:00
abstract:BACKGROUND:Geriatric day hospitals provide multi-disciplinary rehabilitation in an outpatient setting. Concern has been expressed that evidence for effectiveness is equivocal and that day hospital care is expensive. OBJECTIVES:To assess the effects of medical day hospitals for elderly people. SEARCH STRATEGY:We searc...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001730
更新日期:2000-01-01 00:00:00