Presentation Poster Y1

Question 1

Why are increased prolactin levels a benefit?

Answer 1

Aids bonding between mother and baby, as well as a euphoric state and lactation.
It also may aid baby’s lung development

Question 2

Why are cortisol levels a benefit?

Answer 2

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

Question 3

Hypoxia

Answer 3

Fetus is deprived of Oxygen

Question 4

What is reporting biased?

Answer 4

Distortion of presented information due to disclosure or withholding of information.

Question 5

How to avoid selection biased

Answer 5

Double blind trial

Using two researchers to measure the same result (increasing inter-rater reliability)

Randomised numbers (systematic sampling)

Question 6

Why would stratified sampling me good?

Answer 6

It could represent a group in every population, however takes more time and resources

Question 7

Recumbent and semi recumbent positions include

Answer 7

Supine- lying flat

Lithotomy- supine position with hips and knees flexs and legs in stirrups

Lateral- lying on the side

Question 8

Beta endorphins- involved in pain management, possessing morphine like effects- inhibit substance P release

Answer 8

A key protein in the transmission of pain

Question 9

Voluntary movements inhibits sensory systems

Answer 9

A good alternative for pain

Question 10

Mobility affects oxytocin levels and beta endorphins directly and cortisol and prolactin indirectly by control of the environment

Answer 10

Control of the environment is enhanced by ability to mobilise

Question 11

Pelvic changes- expands.

Answer 11

.

Question 12

Hemmerich- computer method. Tracks anatomical landmarks. Predominantly outlet. Clinically meaningful

Answer 12

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.

Question 13

Squatting is the best for maternal joint loading compared to other static positions

Answer 13

= greater pelvic mobility

Question 14

Nokomis- allows pelvic rotation and expansion.

Venacaval compression decreases.

Answer 14

Gravity aids fetus head.

Question 15

Romano and Lothian 2008

Answer 15

Gravitational effects include protecting the birth canal and fetus from excessive pressure that can cause distress.

Question 16

Ambulation can reposition baby

Answer 16

If not, can aid lower back pain.

Question 17

Movement aids slow labour and oxytocin levels

Answer 17

However, more research needs to be conducted on oxytocin augmentation.

Question 18

Less compression of sorts when upright, which means a better oxygen supply to baby.

Answer 18

Also helps uterus contract more strongly and aids fetal positioning

Question 19

Diaz randomly assigned (good for bias) First stage was reduced, caused by higher intensity contractions and larger pelvic diameters

Answer 19

Although a benefit to all, could be more if a benefit to nulliparous women.

Question 20

Flynn et al- smaller sample size, randomly assigned.

Answer 20

Less likely to be prescribed oxytocin if standing or active. First stage is shorter

Question 21

Lawrence et al systematic review- uses reproducible methods to identify, select and critically appraise all relevant research

Answer 21

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

Question 22

Lawrence et al (changes to duration)

Answer 22

Shorter stage but needs to be reassessed due to lack of quantitive and evidence rich and specific data

Question 23

Other effects

Answer 23

Gau et al 2011- increased time upright decreased labour pain and increased self efficacy

Question 24

Circumstances in which mobility and positioning may be unattainable

Answer 24

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