Seratti et al(18)
|
Italy, 2016 |
Documentary prospective study |
Squatting and side lying positions x lithotomy |
Higher rates of severe lacerations in lithotomy position. |
2C |
Meyvis et al(19)
|
Belgium, 2012 |
Retrospective cross-sectional documentary study |
Side lying x lithotomy |
Lower laceration rates and higher intact perineum when adopting a side lying position. |
1C |
Thies-Lagergreen et al(20)
|
Sweden, 2011 |
Controlled RCS* |
Stool x lithotomy and other horizontal positions |
There was no increase in non-severe and severe perineal lacerations with the use of the stool. |
4A |
Brément et al(21)
|
France, 2007 |
RCS*
|
Lateral decubitus x dorsal decubitus |
Lower rates of perineal lacerations in lateral decubitus. |
4A |
Hastings- Tolsma et al(22)
|
United States†, 2007 |
Retrospective documentary study |
Side lying x lithotomy |
Higher risk of lacerations in lithotomy position. |
1C |
Nasir; Korejo; Noorani(23)
|
Pakistan, 2007 |
Case control study |
Squatting x lithotomy |
Reduction in perineal laceration rates in the squatting position. |
2C |
Ragnar et al(24)
|
Sweden, 2006 |
RCS*
|
All-fours x sitting |
All-fours position should be encouraged by professionals. |
4ª |
Bodner-Adler et al(25)
|
Austria, 2003 |
Case control study |
Upright x supine |
There was no association between horizontal position and the occurrence of perineal lacerations. |
2C |
Bomfim-Hyppólito(26)
|
Brazil, 1998 |
RCS*
|
Upright x horizontal |
Lower incidence of 2nd degree lacerations in an upright position. |
2B |
De Jong et al(27)
|
South Africa, 1997 |
RCS*
|
Upright positions vs. horizontal positions |
Higher rates of lacerations in the lithotomy position; 3rd degree were slightly smaller in the upright position. |
4A |
Waldenstrom; Gottval(28)
|
Sweden, 1996 |
RCS*
|
Stool x supine |
No significant differences between the two groups. |
3B |
Golay; Vedam; Sorger(29)
|
United States, 1993 |
Cohort study |
Squatting/squatting x semi-sitting |
Squatting should be encouraged to prevent perineal lacerations. |
1C |
Gardosi; Sylvester; B-Lynch(30)
|
England, 1989 |
Controlled CS†
|
Squatting, knees, sitting upright or standing x lying down |
Reduction of severe lacerations in the squatting position. |
2B |
Gardosi; Hutson; B-Lynch(31)
|
United Kingdom, 1989 |
Controlled RCS*
|
Squatting x reclining |
Higher incidence of intact perineum and lower 2nd degree lacerations in the squatting position. |
2B |
Stewart;Hillan; Calder(32)
|
Scotland, 1983 |
RCS*
|
Stool (squatting) x supine position |
Stool can be used for perineal preservation. |
3B |
Gottvall; Allebeck; Ekéus(33)
|
Sweden, 2007 |
Cohort study |
Upright positions (stool, semi-seated side leaning, squatting, all-fours, standing) x lithotomy and supine |
Lithotomy and squatting may increase severe lacerations. Global effects of various positions are inconclusive. |
2ª |
Da Silva et al(34)
|
Brazil, 2012 |
Retrospective cross-sectional study |
Upright positions x supine position |
Alternatives to dorsal positions can improve perineal integrity. |
2B |
Terry et al(35)
|
United States, 2006 |
Non-randomized CS†
|
Seated/squatting/all-fours x supine |
Upright positions can reduce perineal lacerations. |
2B |
Albers et al(36)
|
Mexico and the United States, 1996 |
Cohort study |
Semi-seated, seated, side lying, other positions x lithotomy |
Lithotomy position should not be used to prevent perineal lacerations. |
1C |
Maheux-Lacroix et al(37)
|
Canada, 2013 |
Retrospective comparative exploratory study |
Upright positions x supine position |
Upright positions may be associated with lower rates of vaginal tears. |
1C |
Roberts; Kriz(38)
|
United States, 1984 |
Retrospective correlational descriptive study |
Semi-seated/All-fours/lateral birth/squatting/standing x lithotomy |
It was not possible to conclude that the position influences the perineal result. |
1C |
Gupta; Brayshaw; Lilford(39)
|
United Kingdom,1989 |
RCS*
|
Squatting x lithotomy |
2nd degree lacerations were more common in the squatting position. |
3A |
Schirmer;Fustinoi; Basile(40)
|
Brazil, 2011 |
RCS*
|
Left side x semi-sitting upright |
Higher frequency of 1st degree lacerations in side lying position. |
4A |
Altman et al(41)
|
Sweden, 2007 |
RCS*
|
All-fours x sitting |
All-fours and sitting upright do not show significant differences in severe lacerations. |
4A |
Baracho et al(42)
|
Brazil, 2009 |
Cohort study |
Squatting/sitting/semi-sitting x supine/lithotomy |
No association between horizontal position and the occurrence of perineal lacerations. |
2A |
Heinz et al(43)
|
Austria, 2001 |
Case control study |
Stool x dorsal position |
Stool can be an alternative in childbirth. |
2C |