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Effect of maternal posture on breech presentation in pregnancy
Breech malpresentation is associated with maternal-infant morbidity and mortality. Maternal knee-chest posture is a clinical practice intended to reduce the incidence of breech presentation and its concomitant risks in pregnancy. However, research on postural management has been inconclusive. This randomized clinical trial investigated whether knee-chest posture is associated with a higher proportion of breech infants converting to cephalic presentation during pregnancy. The study was conducted with 25 pregnant women whose infants were in breech presentation at 34–38 weeks gestation. Gestational age, parity, race, and treatment were evaluated for effect on version using Fisher exact tests. Gestational age, parity and treatment met screening criteria (p ≤ .25) for significance in the univariate analyses. Logistic regression was not employed due to zero cells in some of the univariate contingency tables. Effects of the intervention on infant presentation in labor, mode of delivery, birthweight, and 5-minute Apgar were examined by Fisher exact tests. There was no significant effect of intervention on birth outcomes at the p ≤ .05 level. Data from this study of 25 women were combined with data from two previous randomized trials for the same intervention. There was no effect of knee-chest posture on breech presentation in pregnancies over 36 weeks gestation. Implications for nurses and obstetric care providers include knowing that postural management of breech pregnancy is not yet adequately tested, advising clients accordingly and participating in the research to establish whether knee-chest posture promotes cephalic version of breech presentation.
Founds, Sandra A, "Effect of maternal posture on breech presentation in pregnancy" (2002). Doctoral Dissertations Available from Proquest. AAI3068556.