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Pour une meilleure compréhension du rôle des positions d'accouchement en mécanique obstétricale : analyse biomécanique des postures segmentaires

Abstract : When looking at birthing positions, opinions are strongly divided. According to the literature, the so-called vertical positions, which include the squatting position, seem to lead to more favorable maternal-fetal outcomes than the horizontal positions which include the gynecological position. In fact, the origin of these benefits, particularly from the point of view of obstetric mechanics, remains uncertain. It appears that this lack of clarity comes primarily from a lack of definition of segmental postures found in these delivery positions.The primary objective of this work was therefore to define the segmental postures during different birthing positions and to specify in particular the role of the thigh posture on elements considered as important in obstetric mechanics namely, the orientation of the pelvic inlet and the lumbar curvature.Firstly, a regional epidemiological survey was carried out to document the most frequently adopted childbirth positions and to identify the factors associated with their adoption.Using a method derived inter alia from movement analysis methods based on optoelectronic system, the influence of thigh posture (flexion and abduction) on the posture of the pelvic inlet and the lumbar spine was analyzed firstly during gynecological position and then during squatting position. Finally, the importance of initial thigh posture on segmental movements was evaluated during an obstetric maneuver (Mac Roberts), a maneuver commonly used in cases of shoulder dystocia.This work has highlighted the importance of the characterization of segmental postures for understanding the benefits of one delivery position on another.
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https://tel.archives-ouvertes.fr/tel-01981719
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Submitted on : Tuesday, January 15, 2019 - 11:21:23 AM
Last modification on : Monday, October 12, 2020 - 3:31:06 PM
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  • HAL Id : tel-01981719, version 1

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David Desseauve. Pour une meilleure compréhension du rôle des positions d'accouchement en mécanique obstétricale : analyse biomécanique des postures segmentaires. Biomécanique [physics.med-ph]. Université de Poitiers, 2018. Français. ⟨NNT : 2018POIT2253⟩. ⟨tel-01981719⟩

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