| Description |
A descriptive study was conducted to examine the relationship between changes in maternal position and their effect on blood pressure, maternal pulse, and fetal heart rate during labor. The sample population consisted of 21 subjects. Data were obtained by interview, chart review, and evaluation of vital signs of laboring women in three positions. Blood pressure, mean arterial pressure, maternal pulse, and fetal heart rate were obtained by using a Denamap noninversive blood pressure monitor and Hewlett-Packard fetal monitor. Measurements were taken in supine, left lateral, and elevated positions within five minutes of assuming a position and between five and ten minutes of assuming a position. Supine hypotension symptoms did not occur in any study subject. There was shown to be a statistically significant but clinically irrelevant relationship between position and all dependent variables. Blood pressure measurements were inconsistent with supine hypotension. Decreased values in the lateral as compared to the supine position, may have been due to hydrostatic effect of using the superior arm for measurement, or unobstructed venous return. Maternal pulse was inconsistent with the occurrence of supine hypotension. The increased pulse values in the supine position may have been due to compensation for decreased cardiac output in that position. The fetal heart rate increased from the supine to the lateral to the elevated position. The findings do not support an association between any position and decreased fetal oxygenation. The data showed an increase in all dependent variables in the elevated position. This could be the result of release of aortocaval compression when moved from the supine position. The elevated position was shown not to be deleterious to mother or fetus. The higher the fetal station, the greater the change in fetal heart rate as the subject moved from position to position. The data also showed that higher subject parity may be associated with increased changes in some blood pressure values when moved from position to position. Neither fundal height nor weight of the newborn correlated with the dependent variables. The data demonstrated that supine hypotension did not occur, and the supine position may not result in decreased fetal oxygenation. Care providers must consider each individual carefully in determining beneficial positions during labor |
