DISCUSSION
The approach taken in this meta-analyisis was
different from the one conducted by Gupta
and Nikodem
20
. The outcomes are not very
different from their comparison between
supine or lithotomy position and upright or
lateral position. We too, found an increase in
instrumental deliveries and epsiotomies in
the supine position compared to other
positions and a decrease in blood loss and
postpartum hemorrhage. The decrease in
second degree tears in supine position found
in their study did not reach significance in
ours (p= 0.09). They observed more abnormal
fetal heart rate patterns in the supine
position, whereas we did not. In both metaanalyses, no differences in low Apgar scores
or neonatal resuscitation were found.