Effectiveness of a physical therapy program using peanut ball positions during the first stage of labor on maternal and neonatal outcomes: randomized clinical trial.

The active phase of labor is a crucial stage that determines the progress and success of the delivery process. Prolonged labor during this phase can increase the risk of maternal complications and reduce the comfort of the laboring mother. Various non-pharmacological interventions have been developed to support the physiological progress of labor, including acupressure at the SP6 point and oxytocin massage. This study aims to analyze the differences in the effects of SP6 acupressure and oxytocin massage on the duration of the active phase of labor at the Galala Health Center in the Tidore Islands. This study used a quasi-experimental design with a comparative approach in two intervention groups. The sample consisted of 40 mothers in the first stage of active labor who met the inclusion criteria, with 20 respondents in the SP6 acupressure group and 20 respondents in the oxytocin massage group. The duration of the first stage of labor was calculated from 4 cm cervical dilation to complete 10 cm dilation and recorded using a partograph. Data were analyzed univariately to describe the distribution of labor duration and bivariately using the Mann–Whitney U test to assess the difference between the two groups. The results showed that the median duration of the first stage of labor in the SP6 acupressure group was shorter than in the oxytocin massage group. The Mann–Whitney test showed a statistically significant difference between the two intervention groups (p < 0.05). The conclusion of this study indicates that SP6 acupressure is more effective than oxytocin massage in shortening the duration of the first stage of active labor. These findings support the use of SP6 acupressure as a safe and effective nonpharmacological intervention in intrapartum midwifery care in primary health care facilities.

Introduction: In Banten, in 2019 the cause of maternal death was recorded at 22,5% caused by other causes, one of which was due to prolonged labor, as well as Cimanggu Health Center in 2021 found 1 case of maternal death caused by bleeding the cause was due to prolonged parturition. One way to speed up the progress of labor is by giving oxytocin massage and acupressure massage. The purpose of the study was to determine the effectiveness of giving oxytocin massage and acupressure massage for the duration of the active phase of the first stage of labor at the Cimanggu Health Center, Pandeglang Regency, Banten in 2022. Methods: The research method was a quasi-experimental design with a post-test-only design with control groups, the number of samples was 60 respondents, the sampling technique was purposive sampling, and data analysis using the Independent T-test. Result: The results of the study showed that the duration of the first stage of active labor in the oxytocin massage group obtained an average of = 6,84 hours, the duration of the active phase of the first stage of labor in the acupressure massage group obtained an average of 5,34 hours. The results of the bivariate analysis showed that there was an average difference between oxytocin massage and acupressure massage on the duration of the active phase of the first stage of labor with a p-value of 0,000. Discussion: The conclusion of the study was that there was an average difference between oxytocin massage and acupressure massage on the duration of the active phase of the first stage of labor. Suggestions are expected for health workers, are expected to always be updated, especially in helping mothers give birth to meet the mother's need for comfort in non-pharmacological pain control, one of which is using acupressure or oxytocin massage techniques.

Labor pain is a common complaint. The method used to reduce maternal discomfort should be efficacious and safe for the mother and the child. Several alternative methods have been reported to reduce childbirth pain. This study was conducted to evaluate the effect of kinesio taping combined with breathing exercises on childbirth duration and labor pain. This study was conducted on 40 normal full-term primigravida women during the first stage of labor with regular painful, palpable uterine contraction, and cervical dilatation between 3 and 5cm. They were randomly assigned into two equal groups, group A and group B. Group A (the study group) consisted of 20 women, and group B (the control group) consisted of 20 women. All participants in both groups A and B performed breathing exercises in addition to conventional medical treatment. However, group A patients received kinesio taping at the lumbar region and anterior lower abdomen during the first stage of normal labor. Assessment of all participants in both groups A and B was carried out before and after the treatment program using visual analogue scale (VAS), cardiotocography, and by measuring the duration of the first stage of labor using a stopwatch. There was a nonsignificant difference between group A and group B in pain intensity using VAS in the first stage of labor at the first reading (cervical dilatation: 3–4cm). However, there was a highly significant difference between group A and group B in the pain intensity using VAS in the first stage of labor at the second reading (cervical dilatation: 7–8cm), favoring group A. Furthermore, there was a highly significant difference between group A and group B in the duration of the first stage of labor, favoring group A. These results suggest that kinesio taping combined with breathing exercise is an effective method in reducing labor pain and shortening the duration of the first stage of labor.

To evaluate blood flow Doppler velocimetry during the first and second stages of active labor. A prospective observational study was performed. Patients at term (37-42weeks gestation), with normal fetal heart rate tracing patterns (categorized as category I) were examined during the first and second stages of labor. The sonographic parameters that were measured included the blood flow resistance of the maternal uterine artery (UtA) and umbilical artery (UA). Wilcoxon-matched pair test was used for the comparison of flows between the first and the second stages of labor. UtA and UA Doppler velocimetry measurements were obtained from 31 parturients. The left (LT) and right (RT) UtA pulsatility index (PI) was lower in the second stage of labor as compared with the first stage. However, only the LT side reached a statistically significant difference (0.88±0.32 and 0.73±0.18; P=0.005). Compared with the first stage of labor, UA PI was significantly higher during the second stage of labor (0.72±0.17 vs. 0.84±0.33; respectively, P=0.05). Significant blood flow resistance changes in maternal as well as in fetal blood vessels occur during the second stage as compared with the first stage of active labor.

The objective of this study was to investigate the effects of obstetric gel application on the length of the first stage of labour and perineal trauma in primiparous women. This randomised controlled trial included 110 primiparous women. Women were randomly assigned to the two groups: lubricant gel group and control group. In the intervention group, during cervical dilatation of 4 cm until complete cervical dilatation, 5 ml of water-soluble lubricant gel was used at each vaginal examination. In the control group, routine care was performed. Mean duration of the total length (p = .025), the first (p = .012), and second stage (p = .022) of labour was significantly shorter in the obstetric gel group than control group. Perineal health was significantly better in the gel-applied pregnant women (p < .001). Using obstetric gel at the beginning of the first stage could shorten the total length, the first and the second stage of labour and could protect perineal health. IMPACT STATEMENT What is already known on this subject? Prolonged labour and perineal injuries are a major problem in natural childbirth for primiparous mothers. What the results of this study add? The first (p = .012), and second stage (p = .022) of labour was significantly shorter in the obstetric gel group than in the control group. Perineal health was significantly better in gel-applied pregnant women (p < .001). Using obstetric gel at the beginning of the first stage could shorten the total length, the first and the second stage of labour and could protect against perineal injury. What the implications are of these findings for clinical practice and/or further research? Obstetrical gel lubricant usage in the first stage of labour during the active phase of nulliparous women could shorten the total length, the first and the second stage of labour and could protect perineal health.

Association of abnormal first stage of labor duration and maternal and neonatal morbidity

목적: The aim of this study was to perform a preliminary investigation into the predictive values of the position of the fetal occiput measured during the first and second stages of labor by intrapartum ultrasound for persistent occiput posterior (OP) position and labor dystocia. 방법: This was a prospective cohort study, in which 148 primiparous women with singleton pregnancies were enrolled. The women underwent intrapartum transabdominal sonography and the positions of the fetal head were recorded during the first and second stage of labor. We analyzed the correlation between the position of fetal head and labor course and perinatal outcomes. Statistics were performed using SAS 9.2. 결과: 148 pregnancies were evaluated in the first stage of labor, with 126 of these also evaluated in the second stage. 22 pregnancies were not evaluated during second stage because they underwent Cesarean section during the first stage. 51 of 148 fetuses (34.5%) were found to be in an OP position during the first stage of labor. There were 8 cases of OP position during the second stage, and 6 of these (75.0%) were among the 51 fetuses that were found to be in an OP position during the first stage of labor. 19 of 51 cases with OP position during the first stage of labor (37.3%) and 2 of 8 cases with OP position during the second stage of labor (25.0%) underwent Cesarean section owing to arrest disorder. The rates of Cesarean section in OP position group were significantly higher than those in OA position and OT position group (p=0.0024, 0.0374). Perinatal complications occurred more frequently in OP position group than OA position and OT position groups. But there was no statistically significant correlation. 결론: The results of this study suggest that the position of the head during the first and second stage of labor could be useful indicators for predicting the persistent OP position and labor dystocia. Studies with larger sample sizes are needed to confirm these results.

Abnormal length of first stage of labor in nulliparous women (first pregnancy) can be related by severe anxiety during labor. Based on the preliminary survey in several private maternity clinics at the working area of Delitua Puskesmas, Deli Serdang District, it was found that there was a prolonged first stage of labor (27.65%) in nulliparous women. The purpose of this study was to analyze the influence of anxiety level to the lenght of first stage of labor. The type of this study was an analytic survey with explanatory research type. The samples comprised 40 childbearing women in private maternity clinics of Kasih Ibu,Kurnia,Tanjung,Wanda,and Mayana which were located in the working area of Delitua Puskesmas , Deli Serdang District,using accidental sampling technique. The data were gathered by using questionnaires and analyzed in univariet analysis by using frequency distribution form, and bivariate analysis using Chi Square test. The result of this study showed that the level of anxiety (p = 0.001) significantly related the lenght of first stage of labor in which mothers who had severe anxiety. It is recomended that health providers should provide standardized services to childbearing women, especially to nulliparous women, so that their level of anxiety can be decreased facing the first stage of labor process. It is also recommended that the husbands should support their wives by positive behaviors so they will not think about bad things on their babies and on themselves.

Abnormal length of the first stage of labor in nulliparous women (first pregnancy) can be related to severe anxiety during labor. Based on the preliminary survey in several private maternity clinics at the working area of Delta Puskesmas, Deli Serdang District, it was found that there was a prolonged first stage of labor (27.65%) in nulliparous women. The purpose of this study was to analyze the influence of anxiety level to the length of the first stage of labor. The type of this study was an analytic survey with explanatory research type. The samples comprised 40 childbearing women in private maternity clinics of Kasih Ibu, Kurnia, Tanjung, Wanda, and Mayana which were located in the working area of Delitua Puskesmas, Deli Serdang District, using accidental sampling technique. The data were gathered by using questionnaires and analyzed in the univariate analysis by using frequency distribution form, and bivariate analysis using Chi-Square test. The result of this study showed that the level of anxiety (p = 0.001) significantly related the length of the first stage of labor in which mothers who had severe anxiety. It is recommended that health providers should provide standardized services to childbearing women, especially to nulliparous women, so that their level of anxiety can be decreased facing the first stage of the labor process. It is also recommended that the husbands should support their wifes by positive behaviors so they will not think about negative things on their babies and on themselves.

The birth process is a physiological event. Every mother who will give birth will experience pain as a manifestation of the baby's birth process. The effects of pain experienced by the mother will cause anxiety which often has a negative impact on birth outcomes. Many ways to deal with anxiety during labor are related to reducing pain, but only a few have researched the effect of spiritual guidance on reducing this pain. This study aims to assess the effect of spiritual guidance on the level of anxiety in mothers in the first stage of active labor. This study used a one-group pretest and post-test pre-experimental design on 71 mothers in the first active phase of labor. Anxiety levels were measured using the Hamilton Rating Scale for Anxiety (HSRA). The statistical analysis used is Wilcoxon. The results of the study found that there was a decrease in anxiety from before and after being given spiritual support to mothers in the first stage of labor. It is very important to provide childbirth support such as spiritual guidance to birth mothers in reducing their anxiety levels

Objective: In our part of the world poverty and illiteracy has adversely affected our core objective of pregnancy i.e. healthy mother and healthy child. Exploring the role of a routinely used drug in reducing the duration of labor could be a breakthrough. Present study was planned accordingly to evaluate the effect of phloroglucinol (PHL). Materials and Methods: It was a Randomized controlled trial conducted at Department of Obstetrics &amp; Gynecology, Combined Military Hospital, Bahawalpur from January 2019 to June 2019. This study included 60 cases of age 18 to 40 years, having singleton pregnancy and in active first stage of uncomplicated labor. Patients with history of multiple pregnancies, obstetrical and surgical complications and cardiorespiratory diseases were excluded. The cases were placed randomly into Group A &amp; Group B and given intravenous PHL and a placebo respectively. After this, duration of the first stage of labor was recorded in minutes from when there was 3-4 cm cervical dilatation with regular uterine contractions to complete cervical dilation i.e. 10 cm and descent of the presenting fetal part. Results: Mean duration of active first stage of labor in experimental group A (230.20 ± 52.96 minutes) was significantly higher than that of control group B (345.30 ± 50.57 minutes). Conclusion: This study concluded that intravenous PHL has efficiently reduced the duration of active first stage of labor in these randomly selected nulliparous and multiparous women. PHL is a useful drug serving the purpose of a spasmolytic, analgesic and labor augmentation at the same time.

Uterine activity was studied during labor in 36 women who had previous cesarean sections. There was no difference in uterine activity between those delivered vaginally (66%) or those who n...

The primary objectives of this study were to evaluate the impact of intramuscular meperidine on shortening of the active phase of labor, the neonatal outcome and the rate and severity of perineal lacerations in term pregnant women in the first stage of labor. A total of 571 primiparous term pregnant women delivered vaginally were included into this retrospective study. In 437 of them, meperidine (100 mg IM) at the beginning of the active phase was administered and 134 women did not receive any meperidine dose. The length of labor phases, obstetric lacerations, and neonatal outcomes were recorded. The results of this study showed that meperidine could be used safely as an obstetric analgesic with its additional benefit of shortening the active phase of the first stage and second stage of labor without increased risk of obstetric lacerations and perinatal adverse outcomes. In case of limited use of neuraxial analgesia in a busy state maternity hospital, intramuscular meperidine administration as obstetric analgesia seems beneficial in reducing the length of the active phase of the first stage of labor and the second stage of labor without adversely affecting obstetric lacerations and neonatal outcomes.

Background: Labor pain is a common physiological condition experienced by women during childbirth. Labor pain can have a negative effect on the process of labor if not treated properly. One of the methods of reducing labor pain is deep back massage and distraction. The recitation of Surah Al-Fatihah is believed to reduce pain during childbirth. Aim and Objective: The objective of research was to determine the difference in the effectiveness of the deep back massage method with Al-Fatihah and without Al-Fatihah in reducing pain intensity in primigravidas during active first stage of labor at BPM Bunda, Bukittinggi, in 2016. Materials and Methods: This study used a quasi-experimental design. The population of this research was primigravidas during the active stage of labor. A sample of 20 women was taken using purposive sampling technique. Ten respondents were given deep back massage method without Al-Fatihah recitation and the other 10 with Al-Fatihah recitation. The data were collected through interviews and observations, and analyzed using the paired t-test. Results: The results of the analysis showed that there was a significant relationship between the deep back massage method without Al-Fatihah recitation and a reduction in labor pain, with P = 0.001 and a mean difference between before and after experiments. Analysis of the deep back massage method with Al-Fatihah recitation showed a reduction in labor pain with P = 0.000 and a mean difference between before and after experiments. Conclusions: Deep back massage method with Al-Fatihah recitation is more effective in reducing pain intensity in pregnant women during active first stage of labor.

INTRODUCTION: The use of respiratory exercises during the first stage of labor, recommended by the World Health Organization, improves oxygenation and reduces maternal pain, anxiety, and fatigue. This review examines breathing patterns, evaluating their benefits and potential risks for maternal and neonatal outcomes. METHODS: A search was conducted in the MEDLINE/PubMed, LILCAS, PEDro, EMBASE, CINAHL, CENTRAL, Web of Science, and SCOPUS databases, with no restrictions on period or language. The terms “Breathing Exercises” and “Labor” were used. Randomized and quasi-randomized clinical trials comparing a group using respiratory patterns during the first stage of labor with a control group receiving usual care were included. The Cochrane tool (RoB 2.0) was used to assess the risk of bias, and the certainty of evidence was evaluated using the GRADE system. Quantitative analysis was performed through meta-analyses. RESULTS: Thirteen studies were included. There was a reduction in pain by −1.64 (95% CI, −2.81 to −0.46, I2 99%; T2 2.82; P&lt;.00001), based on very low certainty of evidence, and a reduction in the duration of the second stage of labor by −7.23 minutes (95% CI, −11.08 to −3.38; random effects: I2 0%; T2 0.00; P&lt;.0002), based on moderate certainty of evidence. CONCLUSIONS/IMPLICATIONS: There is moderate evidence that the use of respiratory patterns during the first stage of labor can reduce the duration of the pushing stage and decrease pain intensity, although with very low certainty of evidence. However, there was no difference in other maternal and neonatal outcomes.