Comparación de resultados maternos y neonatales en partos verticales y horizontales en un hospital peruano
Comparison of maternal and neonatal outcomes in vertical and horizontal births in a Peruvian hospitalBarra lateral del artículo
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El manejo de la posición durante el parto influye directamente en la experiencia materna y en los resultados obstétricos. Objetivo: Comparar la incidencia de resultados adversos maternos y neonatales entre las mujeres que tuvieron un parto en posición vertical versus horizontal en el Instituto Nacional Materno Perinatal. Métodos: Estudio analítico, observacional, retrospectivo de cohortes. Se incluyeron 304 mujeres con partos vaginales a término entre septiembre y noviembre de 2022, categorizadas en grupos de parto vertical (n=130) y horizontal (n=174). Se utilizaron análisis bivariados y regresión logística multivariada para comparar resultados. Resultados: Las mujeres en el grupo de parto vertical tuvieron una tasa significativamente menor de desgarros perineales severos (1,5% vs. 5,2%, p=0,041) y una duración menor del segundo estadio del parto (45,2 vs. 58,9 minutos, p<0,001). Tras el ajuste, la posición vertical se mantuvo como factor protector independiente contra desgarros severos (OR ajustado 0,28; IC 95% 0,09-0,89). No se observaron diferencias significativas en hemorragia postparto o resultados neonatales adversos. Conclusión: En nuestra cohorte, la posición vertical se asoció con resultados perineales maternos más favorables, respaldando su promoción como opción segura en la práctica clínica.
The management of position during labor directly influences the maternal experience and obstetric outcomes. Objective: To compare the incidence of maternal and neonatal adverse outcomes between women who delivered in vertical versus horizontal birthing positions at the National Maternal Perinatal Institute. Methods: Analytical, observational, retrospective cohort study. A total of 304 women with singleton, term, vaginal deliveries between September and November 2022 were included, categorized into vertical (n=130) and horizontal (n=174) birth groups. Bivariate analyses and multivariate logistic regression were used to compare outcomes. Results: Women in the vertical birth group had a significantly lower rate of severe perineal tears (1,5% vs. 5,2%, p=0,041) and shorter duration of the second stage of labor (45,2 vs. 58,9 minutes, p<0,001). After adjustment, vertical position remained an independent protective factor against severe tears (Adjusted OR 0,28; 95% CI 0,09-0,89). No significant differences were observed in postpartum hemorrhage or neonatal adverse outcomes. Conclusion: In our cohort, vertical position was associated with more favorable maternal perineal outcomes, supporting its promotion as a safe option in clinical practice.
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