Vacuum-assisted birth in maternal lateral posture versus lithotomy. A simulation study
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Marcos Javier Cuerva1, Beatriz De Santiago2, Marta Cortés3
1Hospital Universitario La Paz, Department of Obstetrics, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid, Spain; Hospital San Francisco de Asís, UPA (Affective Birth Unit), Madrid, Spain; School of Health Sciences, Universidad Alfonso X el Sabio, Madrid, Spain.
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.
