Presentation Poster Y1 Flashcards
Why are increased prolactin levels a benefit?
Aids bonding between mother and baby, as well as a euphoric state and lactation.
It also may aid baby’s lung development
Why are cortisol levels a benefit?
Cortisol is important due to it triggering estriol which is a form of oestrogen that inhibits synthesis of progesterone by the placenta and aids smooth muscle in preparation for labour, aiding contractions
Hypoxia
Fetus is deprived of Oxygen
What is reporting biased?
Distortion of presented information due to disclosure or withholding of information.
How to avoid selection biased
Double blind trial
Using two researchers to measure the same result (increasing inter-rater reliability)
Randomised numbers (systematic sampling)
Why would stratified sampling me good?
It could represent a group in every population, however takes more time and resources
Recumbent and semi recumbent positions include
Supine- lying flat
Lithotomy- supine position with hips and knees flexs and legs in stirrups
Lateral- lying on the side
Beta endorphins- involved in pain management, possessing morphine like effects- inhibit substance P release
A key protein in the transmission of pain
Voluntary movements inhibits sensory systems
A good alternative for pain
Mobility affects oxytocin levels and beta endorphins directly and cortisol and prolactin indirectly by control of the environment
Control of the environment is enhanced by ability to mobilise
Pelvic changes- expands.
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Hemmerich- computer method. Tracks anatomical landmarks. Predominantly outlet. Clinically meaningful
Very quick to do, can be repeated, doesn’t need consent, doesn’t require participants or examiners.
Doesn’t take into account human differences and anatomical differences.
Squatting is the best for maternal joint loading compared to other static positions
= greater pelvic mobility
Nokomis- allows pelvic rotation and expansion.
Venacaval compression decreases.
Gravity aids fetus head.
Romano and Lothian 2008
Gravitational effects include protecting the birth canal and fetus from excessive pressure that can cause distress.
Ambulation can reposition baby
If not, can aid lower back pain.
Movement aids slow labour and oxytocin levels
However, more research needs to be conducted on oxytocin augmentation.
Less compression of sorts when upright, which means a better oxygen supply to baby.
Also helps uterus contract more strongly and aids fetal positioning
Diaz randomly assigned (good for bias) First stage was reduced, caused by higher intensity contractions and larger pelvic diameters
Although a benefit to all, could be more if a benefit to nulliparous women.
Flynn et al- smaller sample size, randomly assigned.
Less likely to be prescribed oxytocin if standing or active. First stage is shorter
Lawrence et al systematic review- uses reproducible methods to identify, select and critically appraise all relevant research
Finds include large sample sizes with good methods and can remove extraneous variable effects of research
More reliable and enhanced precision of effect estimate.
However, overall quality can be decreased if using poor quality studies.
All participants need to be similar and individual differences cannot be ignored when discussing research
Not all questions of research will be clinically relevant
Lawrence et al (changes to duration)
Shorter stage but needs to be reassessed due to lack of quantitive and evidence rich and specific data
Other effects
Gau et al 2011- increased time upright decreased labour pain and increased self efficacy
Circumstances in which mobility and positioning may be unattainable
Disabled mothers- adjustments weren’t made
Anxious- nulliparous women were found time have more anxiety surrounding mobility
Chapman- CTG monitoring- cost benefit analysis.
Gupta 2000- less contemporary but more meaningful and can be used in support for other more recent research
Lawrence 2011- large sample size, but 2013 research may be more appropriate
