Use of the prone position in pregnant women with COVID-19 or other health conditions.
Francisco Marcelo Leandro Cavalcante, Cristina da Silva Fernandes, Luanna Dos Santos Rocha and 3 others
PMID 34755775WHAT IT FOUND
Pregnant women who were positioned prone had reported improvements in oxygenation and gas exchange, but the evidence was mostly case reports and experts' recommendations, with no tested protocol.
Key findings
01The final sample consisted of 11 studies, and case reports and experts' recommendations were the most common types.
02No included study reported the use of protocols or checklists for the procedure.
03Two studies pointed out disadvantages: possible severe hypotension from aortocaval compression, and difficulty monitoring fetal status or performing emergency Cesarean section.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 11 studies, and most were case reports or experts' recommendations, so it cannot establish that prone positioning works or is safe. No included study reported a protocol or checklist, so there is no tested procedure to copy. Most studies did not report disadvantages or adverse events, so harms may be missing. Fetal monitoring and emergency Cesarean access can be difficult in the prone position. The search was for prone positioning in pregnant women with any health condition, not specifically COVID-19, so the evidence may not isolate the pregnant COVID-19 group.
The easy way to misread this
Do not read this as proof that prone positioning is safe or effective in pregnant women with COVID-19. The review included 11 studies, most of them case reports or experts' recommendations, and no study reported a protocol or checklist.