Comparación de las complicaciones maternas y neonatales entre el parto en posición vertical y en posición Litotómica en el Centro de Salud Carlos Elizalde en el período 2014-2016

Abstract

Background: The vertical and lithotomic position during the childbirth have advantages and disadvantages. This research presents its findings. Objective: Identify and compare maternal and neonatal complications associated with vertical and lithotomy delivery. Methodology: This research was analytic cross-sectional. 884 maternal medical records attended in the Carlos Elizalde Health Center of Cuenca 2014-2016 was reviewed. We studied: postpartum hemorrhage, perineal tears, need for episiotomy, APGAR score, presence of meconium fluid and neonatal trauma. We use frequencies, percentages, mean, median and standard deviation. We determine its relationship with the Chi square test and Odds Ratio. Results: 80,4% chose the lithotomy and 19.6% the verticality. With the first position, a major percentage required episiotomy (5,1% vs. 0,6%), but with the vertical there were more tears (48,6% vs. 45,6%), postpartum hemorrhage (0,8% vs. 0,3%). %). Neonates with APGAR under the first minute (0,6% vs 0,6%) decreased to the fifth minute, with vertical posture (0% vs 0,4%); the presence of meconium liquid (17,9% vs 17,3%) the variation was minimal. Vertically, cephalohematoma was major (2,3% vs. 0,3%), and caput succedaneum with lithotomy (15,6% vs. 11,6%). The vertical position, is a protective factor against episiotomy (OR: 0,109 IC: 0,0148 – 0,8007; p: 0,008). The presence of tears (OR: 0,887 IC: 0,636-1,237; p: 0,719), postpartum hemorrhage (OR: 0.818 IC: 0,234-2,860; p: 0,092), APGAR during the first minute (OR: 1,027 IC: 0,114-9,252; p: 1) and fifty minute, the presence of meconium liquid (OR: 1,043 IC: 0,675- 1,611; p: 0,847), caput succedaneum (OR: 0,70 IC: 0,42-1,17; p: 0,178) y cephalohematoma (OR: 2,78 IC: 0,77- 9,96; p: 0,216) weren´t associated statistically with position during the delivery’s expulsive phase. Conclusion: The lithotomic position is more frequent; in this position there were more cases of tears grade II, IV in contrast the vertical where were tears grade I and III mainly. Cephalohematoma is more frequent in the vertical and caput succedaneum in the lithotomic. The vertical position protects against the need for episiotomy