CHILD BIRTH

COMPARISON OF COMPLICATIONS BETWEEN LITHOTOMY POSITION AND SQUATTING POSITION DURING

Abstract

Objectives: The purpose of the study was to compare the complications of
delivery in squatting and lithotomy position of mother. Study Design: Randomized controlled
trial. Setting: Gynecology/Obstetrics Unit-II, Sandeman Provincial Teaching Hospital, Quetta.
Period: 6 months (05 Oct, 2011 to 05 April, 2012) Methods: Hundred and fifty one patients with
lithotomy position in delivery were compared with hundred and fifty one patients with squatting
position in delivery regarding risks of perineal tears, periurethral tear, extended episiotomy,
instrumental delivery, caesarean section and primary postpartum hemorrhage. Data was
recorded on a specially designed Performa and was analyzed by using SPSS.V. 10. Results
were compared using Chi-square test by keeping the p-value of < 0.05 as significant. Results:
151 patients in lithotomy position and 151 patients in squatting position were compared and
studied for complications during delivery. Extension of the episiotomy was observed in (7%) of
non-squatting groups. There were no extensions of episiotomy in squatting group. There were
no second degree, or third degree perineal tears in squatting group which were encountered
in (9%) patients in the lithotomy position group (P<0.05). Forceps application was also less
in squatting position group 11% patients, whereas 24% patients were delivered by forceps
in lithotomy group, (P<0.05). One patient in the lithotomy position had to have a caesarean
section due to persistent occipito-posterior position. There was no case of retained placenta
or postpartum hemorrhage in squatting group whereas there were 4% cases of retained
placenta and 1 case of postpartum hemorrhage due to atony of the uterus in lithotomy position
group. Conclusions: It appears that the routine use of lithotomy position may have some
disadvantages in terms of more instrumental deliveries and episiotomies. Moreover women
experience significant pain in this position. It is suggested that more trials should be conducted
and the position at the moment of birth should be registered to measure its influence on birth
outcome.