The Effect of knee - chest position on turning breech to cephalic presentation in pregnant women: randomized clinical trial

Document Type : Original Article


1 M.Sc. Student of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Professor, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Breech presentation is one of the most abnormal presentations of fetus at term pregnancy, and cesarean delivery is performed in most cases. Positioning techniques is one of the methods which is recommended to turn breech presentation into cephalic presentation. This study was performed with aim to determine the effect of knee-chest position on breech presentation turning to cephalic presentation in pregnant women.
Methods: This randomized clinical trial was conducted on 84 pregnant women with breech presentation and gestational age of 34-36 years referred to health centers of Mashhad in 2016-2017. The subjects were randomly divided into intervention and control groups. The intervention group, in addition to routine prenatal care, performed knee-chest position for 10-15 minutes for ten days, three times daily. The control group received routine care. The data collection tool was personal characteristics and midwifery information form, recording the mother's knee-chest position, and follow-up form. The fetus presentation was screened immediately after intervention and during delivery in both groups. Data were analyzed using SPSS software (version 23), independent t-test, Chi-square, Fisher exact test, Mann-Whitney test and logistic regression. P < 0.05 was considered statistically significant.
Results: The results of logistic regression showed that immediately after the intervention, the mothers of the intervention group had 3.8 times of the chances of fetus presentation turning to cephalic than the women in the control group (confidence interval: 1.467-16.415, OR=3.8, P=0.01). Also, this chance was 3.43 times during delivery (confidence interval: 1.095-10.745, OR=3.43, P=0.034).
Conclusion: The mother’s knee-chest positioning can turn breech presentation to cephalic. Therefore, it is recommended to use this position along with other prenatal care for qualified mothers in health care centers.


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