In some deliveries, the baby is placed in the maternal pelvis looking up instead of down, which makes it difficult to leave and increases the risk of caesarean section and instrumented deliveries.
A midwife at Vall d'Hebron Hospital, Vanessa Bueno, has designed an ergonomic cushion that facilitates the rotation of the baby's head in childbirth and that, in addition, helps to rest in the third trimester of pregnancy.
In two month trial 120 pregnant women have used it and reduced caesarean sections and the use of forceps by 16%, according to data from the Barcelona center.
How does it work?
At the time of delivery, it is necessary for the baby to be looking down. But, in approximately 40% of women, it is looking up. If this incorrect position is not corrected, it is necessary to perform a C-section or use forceps.
In Babies and more When can a vaginal delivery be attempted (and when not) if the baby comes from buttocksThis is explained by the midwife of the delivery room of the Vall d'Hebron Hospital in Barcelona, Vanessa Bueno. And he adds that:
“This postural cushion is designed in such a way that women, lying on their side, place it between their legs to open the diameter of the pelvis and cause internal rotation of the knee of the upper leg. In this way, the cushion helps to turn the head of the fetus down, as it finds more space in the pelvis and the delivery can be vaginal. ”
It also explains the midwife:
"The use of this cushion during the hours of dilation is also very useful if the orientation of the fetus is correct, because when causing the opening of the pelvis, it has more space to leave."
Improves rest in the third trimester
In addition to its application to facilitate vaginal delivery, this cushion helps any pregnant woman to improve her rest during the third trimester of pregnancy. Vanessa points out Good:
“The resting position that is recommended for pregnant women, to improve oxygenation of the fetus and reduce maternal blood pressure drops, is the lateral recumbency. Therefore, this pillow is ideal to achieve and maintain this position for many hours, since it avoids discomfort and lumbar pain ”.
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The origin of this cushion is in a clinical trial conducted by the midwife on 'how to facilitate the rotation of the fetus during childbirth when a malposition occurs.'
The ideal position to achieve it, according to Vanessa Bueno, author of the study, is that of Sims modified, with the woman of lateral recumbency (lying on her side) and the upper leg parallel to the lower one and the knee rotated inwards. Hence the cushion is called Easysims (which makes it easy to maintain the Sims posture).
“To evaluate the effects of this posture in childbirth we did a study using the legs of the stretcher to raise the leg with the woman on the side. The results showed that there were more vaginal deliveries, caesarean sections were reduced by 16%, and maternal and fetal morbidity was reduced, as well as hospital stay and post-emergency visits, because fewer complications occur. ”
The research involved 120 women who went into labor with the baby badly placed, looking up. With 60 of them the Sims posture was used, while the other half was able to choose the posture that was most comfortable for him.
The results of the trial, published in the journal Birth showed that:
Babies rotated their position in 50.8% of cases when the mother adopted the Sims posture, while only 21.7% of the children of pregnant women who opted for a free posture during dilation did so.
The number of vaginal deliveries with the Sims posture were higher compared to another position (84.7% versus 68.3%).
Only the only data available because currently, as the midwife tells us, they have six cushions in the maternity center of Vall d'Hebron and their use has already been internalized in the practice of childbirth since May 2018, so they do not save Current records of the benefits of its use.
The midwife explains that the women felt satisfied with the labor done in this position, although the use of the legs of the obstetrics chair reduced comfort. Hence, the idea of the cushion, which can be provided by the healthcare staff to the pregnant woman, even if she has no birth training.
"The cushion is designed so that the woman adopts the correct position, while before we had to manipulate the angle of opening of the knee, turning it in the leg", explains the midwife.
At the moment, EasySims is not yet available to all pregnant women. The intention of its creator is that "That the model is acquired by a company for its commercialization and distribution, and in this way it can reach other hospitals and homes."
Via and Photos | Vall d'Hebron Hospital
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