PS-C06-3: QUANTITATIVE CARDIAC AUTONOMIC OUTCOMES OF HYDROTHERAPY DURING CHILDBIRTH

Abstract

Objective: Most hydrotherapy studies during childbirth report findings related to pain using a widespread set of subjective measures. In this study we evaluated warm shower hydrotherapy s effects during childbirth through ECG biomarkers as quantitative cardiac autonomic outcomes. Design and Methods: This was a prospective single blind cohort study. The cardiac autonomic function was assessed using heart rate variability (HRV) measures during a deep breathing test using an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. Labor pain and anxiety were assessed using the Visual Analogue Scale for Pain (VASP) and the Beck Anxiety Inventory (BAI), respectively. A total of 105 pregnant women in the first stage of labor who received warm shower hydrotherapy, intravenous analgesia (scopolamine + sodium dipyrone), or spinal anesthetic (bupivacaine + morphine) were enrolled. Results: Parasympathetic modulation reflected through RMSSD (root mean square of successive RR interval differences) was significantly reduced by hydrotherapy and intravenous analgesia (before vs. after mean rank diff. 35.73 and 65.93, respectively, p < 0.05). Overall HRV (SDNN, standard deviation of RR intervals) was significantly decreased only by intravenous analgesia (before vs. after mean rank diff. 65.43, p < 0.001). Mean heart rate was significantly increased by intravenous analgesia, while spinal anesthesia reduced it and hydrotherapy did not alter it (before vs. after mean rank diff. -49.35∗, 70.38∗, -24.20NS, respectively, ∗ p < 0.05, NS not significant). Conclusions: This study s findings give quantitative support for the use of warm shower hydrotherapy during labor. This study suggests that warm shower therapy may alter the sympathovagal balance, resulting in a shift towards sympathetic predominance as a result of parasympathetic withdrawal, as well as a better anticipation of higher levels of stress during labor. The dependability of hydrotherapy as a nonpharmacological treatment is linked to the completion of more clinical research demonstrating quantitative evidence via outcome biomarkers to support indications pertaining to stress and birth progress.