Effect of Prone Positioning on Hemodynamic Parameters among Pregnant Women with COVID-19-related Hypoxemia

Document Type : Original Article

Authors

1 Woman's Health and Midwifery Nursing Department, Faculty of Nursing, Mansoura University, Egypt.

2 Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Egypt.

3 Critical Care and Emergency Nursing Department, Faculty of Nursing, Mansoura University, Egypt

Abstract

The current study aimed to evaluate the effect of prone positioning on hemodynamic parameters
among pregnant women with COVID-19-related hypoxemia. Materials and method: A quasi
experimental pre-posttest design was utilized. The study was carried out at the ICU in Mansoura
university hospital, one of the isolation hospitals assigned to receive covid-19 patients. A purposive
sample consisting of 36 pregnant women with confirmed COVID-19 was selected according to the
inclusion criteria. Data was collected through a Structured Interview Questionnaire, Hemodynamic
and Oxygenation Parameters chart, and Visual Analog Scale for dyspnea and discomfort. Results:
There was a significant difference between pre and post-test results in favor of post-intervention.
Whereas, there was an improvement in most hemodynamic parameters mean scores after prone
positioning evidenced by a significant increase in the average measurement of Peripheral oxygen
saturation, PH, Arterial oxygen saturation, and PaO2 and a significant decrease in the average
measurement of Respiratory Rate, PaCO2, PaO2/FiO2, and heart rate. Also, the fetal heart rate mean
scores significantly decreased from 165.25 ± 18.10 beats/minute to 148.97 ± 14.47 beats/minute
after prone positioning. Moreover, there was a significant improvement in dyspnea levels after
applying for the prone position; the moderate and severe dyspnea decreased from 58.3% to 8.3%
and the discomfort level had shown significantly decreased. There was a positive significant strong
(r=0.924, P<0.001) correlation between dyspnea and discomfort level before practicing prone
positioning. Conclusion: The current study findings highlighted that applying a prone positioning
had a highly statistically significant effect on improving the hemodynamic parameters and
decreasing dyspnea and discomfort levels among pregnant women with COVID-19-related
hypoxemia as well as the fetal heart rate. Recommendations: Large-scale studies in different ICUs
in many hospitals are needed to provide strong evidence about the effectiveness of the prone
position in non-intubated and intubated pregnant patients infected with COVID-19.

Keywords

Egyptian Journal of Health Care
Volume 13, Issue 3
September 2022
Pages 1412-1424

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