Active Phase Of Labor Research Articles

Effect of Listening Music on Nulliparous Singleton Pregnancies Who Underwent Induction of Labor: A Randomized Clinical Trial.

A recent randomized clinical trial (RCT) showed that listening to music reduces the pain level and anxiety levels in women with spontaneous labor at term. The effect on pregnant women undergoing induction of labor is still unclear.This study aimed to test the hypothesis that in nulliparous women with singleton pregnancies, undergoing induction of labor at term, listening to music would reduce the pain level during labor. Parallel group, non-blinded, RCT conducted at a single center in Italy. Nulliparous women with singleton pregnancies and vertex presentation, admitted for induction of labor with either oral or vaginal prostaglandins, between 370/7 and 420/7 weeks, were randomized in a 1:1 ratio to receive music during induction of labor or no music during induction. The endpoints of the trials were the pain level during induction, and in the active phase of labor, recorded using the visual analog scale for pain, ranging from 0 (no pain) to 10 (unbearable pain). The effect of music use on each outcome was quantified as the mean difference (MD) with a 95% confidence interval (CI). During the study period, 30 women agreed to take part in the study, underwent randomization, and were enrolled and followed up. Fifteen women were randomized in the music group and 15 in the control group. No patients were lost to follow-up for the primary outcome. Pain level during the induction procedure was 8.8 ± 0.9 in the music group, and 9.8 ± 0.3 in the control group (MD -2.60 points, 95% CI -3.94 to -1.26; p < 0.01). Music during labor and delivery was also associated with decreased anxiety during the induction procedure (MD -3.80 points, 95% CI -5.53 to -2.07; p < 0.01). In nulliparous women, listening to music during the induction of labor reduces pain and anxiety levels. · Music listening has a modulatory effect on the human stress response.. · Music listening may generate beneficial changes in the autonomic nervous system and the HPA axis activity that should be conducive to the stress recovery process.. · Listening to music during induction of labor resulted in a significant lower pain..

Assessment of Midwives’ Knowledge and Application of the Modified WHO Partograph at Ga South Public Health Facilities, Greater Accra, Ghana

Background The partograph, one of the vital tools available for the midwife, was originally developed from Friedman’s 1954 Cervicograph by Philpott and Castle in 1972. It was later modified and adopted by the WHO as a universal ‘gold standard’ tool for recording and monitoring progress in labour and providing interventions in cases of abnormal labour. The goal of this study was to assess the level of knowledge of midwives and their utilisation of the modified WHO partograph at the Ga South Municipality in the Greater Accra Region of Ghana. Methodology An institution-based quantitative cross-sectional study was conducted within the municipality from February to March 2019. One hundred and ten (110) midwives were recruited using the census approach. Data were collected using a structured self-administered questionnaire. STATA statistical software version 14 was used for descriptive analysis and results were reported in the form of percentages and frequencies using charts and tables. Pearson’s Chi-Square estimation was also performed to test the association between selected variables with a p value &lt;.05 as the threshold for statistical significance. Results Of the 110 participants, 105 (95.5%) of the midwives could properly describe the partograph and 104 (94.5%) understood that it was used as a tool for vital decision-making, while 92 (83.6%) indicated that partograph contributes in reducing maternal and new-born deaths. Almost all participants, 109 (99.09%) knew all the parameters of the partograph and were also aware that plotting the partograph begins at a cervical dilation of 4 cm. Also, while a good number of participants 103 (93.64%) knew that cervical dilation on the partograph is carried out every four hours during the active phase of labour, 110 (100%) indicated that progress of labour is assessed by the degree of cervical dilation and descent of the presenting part. Routine usage of the partograph was recorded among the majority of midwives, 102 (92.7%), to record and monitor the progress of labour in expectant women. Bivariate analysis showed a significant association between the use of the modified WHO partograph and the knowledge of midwives on Ghana Health Service (GHS) policies ( p = .045). There was, however, no positive association determined among age ( p = .66), rank ( p = .77), years of professional experience ( p = 1.00), place of work ( p = .51), work shift and highest qualification ( p = 1.00) as far as knowledge and use of the WHO modified partograph are concerned. Conclusion The findings of the study underscore the desirable level of knowledge and usage of the partograph among study participants. This affirms that the knowledge and usage of the partograph within the facilities in Ga South health facilities hold the prospect of enhancing the safety of expectant mothers.

The Length of Xiphoid to Fundus as a Measure of Labor Progress: A Cross-sectional Study

Background: Vaginal examination is widely recognized as the most common method for monitoring labor progress. However, researchers are currently exploring alternative methods, which are potentially less invasive or aggressive, to assess labor progress. Objective: This study aimed to assess the correlation between the length of the xiphoid to the fundus and the cervical dilation in the active phase of labor. Methods: This cross-sectional study was conducted on 180 pregnant women in Varamin, Iran. The participants were recruited using convenience sampling. Data were collected using a researcher- made questionnaire that included specific items regarding demographic characteristics, health status, and a checklist to record the results of examinations and labor progress. The collected data were analyzed using descriptive statistics, correlation tests, and multiple linear regression with SPSS 22 software. The significance level was considered to be p &lt;0.05. Results: A total of 174 eligible women participated in the study, with a mean age of 25.90 ± 4.56 years (mean±SD) and a mean gestational age of 39.71 ± 1.03 weeks. There was a significant negative correlation between the length of the xiphoid to the fundus and cervical dilatation (p = 0.0001, r = -0.568). Conclusions: The study revealed a significant negative correlation between the length of the xiphoid to the fundus and the cervical dilation. Therefore, the xiphoid to fundus measurement can serve as an alternative and complementary examination in cases that need frequent vaginal examinations.

Effect of topical magnesium sulfate on labor duration and childbirth experience: a randomized controlled trial

BackgroundMagnesium sulfate is used topically to reduce the duration of labor in some regions of the country. However, there is insufficient evidence about its effectiveness. This study aimed to determine whether topical magnesium sulfate reduces labor duration and improves childbirth experience (primary outcomes).MethodsIn this randomized controlled trial, the participants were 98 women with low-risk, singleton, and full-term pregnancies admitted to a teaching hospital in Iran. They were randomly assigned to the intervention group (receiving 50% magnesium sulfate) or the control group (receiving distilled water) stratified by parity and onset of labor. The participants, interventionists, and data collectors were blinded. During the vaginal examination at the beginning of the active phase of labor, 10 mL of magnesium sulfate or distilled water was poured on the cervix of the uterus. Data collection was performed by the researcher with continuous monitoring up to two hours post-delivery and follow-up at 4–5 weeks postpartum. The Childbirth Experience Questionnaire 2.0 was used to examine childbirth experience. We performed a modified intention-to-treat analysis, excluding those whose outcome of interest could not be assessed. Independent-samples t-tests were used to compare the groups in terms of the mean of the primary outcomes.ResultsParticipant recruitment took place between December 2021 and December 2022. Thirty-three percent were primiparous and 37% had induced labor. Three women in the intervention group and seven in the control group underwent emergency cesarean sections. All 49 women assigned to each group were included in the analysis of labor duration outcome, while one and two women were excluded from the analysis of childbirth experience score due to loss to follow-up. In the intervention group, compared to the control group, the mean duration of the intervention until delivery was significantly shorter (1.59 vs. 2.93 h; MD -1.34, 95% CI [-1.88 to -0.79]) and the childbirth experience score was higher (3.1 vs. 2.3, MD 0.84; 95% CI [0.59 to 1.08]).ConclusionsAccording to the results of this trial, pouring 10 mL of 50% magnesium sulfate on the cervix at the beginning of the active phase of labor probably reduces labor duration and improves the childbirth experience.Trial registrationEthics Committee of Tabriz University of Medical Sciences: IR.TBZMED.REC. 1400.726. Iranian Registry of Clinical Trials: IRCT20100414003706N40 Registration date: 21/11/2021 (https://en.irct.ir/trial/58323).

Abnormal Uterine Action

The uterus has three distinct layers the endometrium, myometrium, and perimetrium each playing a crucial role in the labour process. The transition from the latent to the active phase of labour is marked by an increase in the intensity and duration of contractions, with shorter intervals between them. Abnormal uterine actions can significantly contribute to dystocia, or difficult labor.T here is two main types of abnormal uterine activity that can lead to complications:  Hypotonic Uterine Activity: This occurs when the resting tone of the uterine muscle is low, resulting in weak or infrequent contractions. This can delay labour progress and may necessitate interventions.  Hypertonic Uterine Activity: In this case, the uterine muscle tone is elevated, leading to frequent but ineffective contractions. This can result in prolonged labour and increased maternal discomfort. Both conditions can confuse the progression of labour and may require careful management to ensure a safe delivery. Effective monitoring and interventions can help address these issues and improve labour outcomes.

Evaluation of the Effectiveness of Obstetric Lubricant Gel in Labor in Nulliparous and Primiparous Women: A Randomized Controlled Study

Aim: Our hypothesis was that lubricating gels used at the beginning of the active phase of labor could reduce the incidence of episiotomies and shorten the duration of labor. This study aims to investigate and confirm this theory with a randomized controlled trial. Material and Methods: A prospective randomized controlled trial was conducted at obstetrics and gynecology department of a university hospital between January 2017 and April 2017. The study included 102 nulliparous and 93 primiparous singleton pregnancies. 50 primiparous women and 47 nulliparous patients were randomly assigned to the obstetric gel group. Obstetric gel was applied to participants in the study groups at the beginning of the active phase of labor. Outcomes were episiotomy rates and duration of labor. Results: Episiotomy rates were significantly lower in nulliparous obstetric gel group (36.1% and 63.6%, p=0.005). The duration of the active phase of the first and second stage of labor was significantly lower in the obstetrical gel groups compared to the control groups in both parities (150 ± 86 and 203. 5 ± 134, p=0.021, 28.8 ± 18.2 and 62.6 ± 53.8, p

Impact of fetal spine alignment according to maternal lateralization during early labor on maternal comfort and birth outcomes: A prospective cohort study in Kelantan, Malaysia.

Maternal positioning during labor significantly influences maternal comfort. This study aims to identify the preferred maternal lateral position during the latent phase and examine the impact of alignment between maternal lateralization and fetal spine positioning during the active phase of the first stage of labor on maternal comfort. Pregnant women in the first stage of labor beyond 37 weeks of gestation were recruited over six months from March to August 2020 for this prospective cohort study at Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia. Eligible individuals were randomly allocated to align with the fetal spine (n=180) or oppose it (n=180). Fetal spine positions were confirmed via transabdominal ultrasound. Maternal mean comfort scores were assessed using the established Maternal Comfort Assessment Tool. Statistical analysis was performed using IBM SPSS version 27, with a p<0.05 considered significant. There was a significant association between the preferred maternal position during the latent phase and concordance with the same maternal lateralization-fetal spine alignment (p<0.001). Higher mean comfort scores were observed when the maternal lateral position matched the fetal spine alignment during the active phase of labor. There was a significant association of normal CTG tracings when the maternal position was aligned with the fetal spine (p<0.001). Parturients preferred lying in alignment with the fetal spine lateralization during the latent phase. This position also offers increased comfort during the active phase of labor. It highlights the importance of considering maternal-fetal alignment as a critical factor in intrapartum care.

Psychometric Properties of the Turkish Version of the Rating Scale of Pain Expression during Childbirth Scale (ESVADOPA-TR).

Evaluation of a specific and dynamic pain, such as labor pain, with a situation-specific measurement tool will increase the quality of care given during childbirth. The Rating Scale of Pain Expression during Childbirth (ESVADOPA) is a situation-specific measurement tool for labor pain. The aim was to examine the psychometric properties of a Turkish version of the ESVADOPA scale. This study utilized a methodological design. Participants were 158 pregnant women at term and in spontaneous labor. Two measurements were performed during the passive and active phases of labor. To avoid bias between the raters, all the evaluations were performed by a single midwife. Validity analyses of the scale were performed using exploratory factor analysis and confirmatory factor analysis. The scale was composed of a one-factor structure that had an eigenvalue of over 1 and explained 71.79% of the variance. Cronbach's alpha internal consistency coefficient of the scale is 0.92. An analysis of the factor structure showed that the item factor loads ranged between 0.729 and 0.897. In the confirmatory factor analysis, the results showed that the data had a good fit with the model. The Turkish version of the ESVADOPA was found to have high reliability and validity for determining the expression of pain during childbirth.

Umbilical arterial blood lactate as predictor of early neonatal outcome and evaluation of intrapartum asphyxia

BackgroundPerinatal asphyxia is a leading cause of under-5 mortality and exerts great pressure on the health system. Adequate foetal monitoring in labour is paramount in the early detection of foetal distress to prevent perinatal asphyxia. Several methods of foetal monitoring are in use with varying efficacy. This study investigated the efficacy of umbilical arterial (UA) lactate assay in predicting adverse perinatal outcomes. MethodologyThis was a prospective longitudinal study involving 160 pregnant women in the active phase of labour at term who met the inclusion criteria. They were recruited using a consecutive sampling technique and underwent a cardiotocography. Then they were classified into normal and abnormal cardiotocographic groups. At delivery, the UA blood of all of the babies was collected and assayed for serum lactate, and the levels were correlated with the perinatal outcome. The perinatal outcomes were measured by Apgar scores, admission into the neonatal unit, and hypoxic ischaemic encephalopathy. Analysis was done to determine the sensitivity and specificity of UA lactate in predicting birth asphyxia, hypoxic ischaemic encephalopathy, and neonatal unit admission. ResultsThe mean age ± standard deviation (SD) between the two cardiotocography (CTG) groups, normal years (30.55 ± 5.59) and abnormal years (29.86 ± 5.51), were similar. A critical UA lactate concentration > 9.1 mmol/L predicted Apgar scores < 7 at 5 min with a sensitivity and specificity of 76.47% (CI: 50.1–93.2) and 91.55% (CI: 85.7–95.6%), respectively. Also, the need for neonatal unit admission was predicted at a cut-off point >9.1 mmol/L with a sensitivity of 61.90% (CI: 38.4–81.9) and specificity of 91.30% (CI: 85.3–95.4). Umbilical artery lactate levels > 11.2 mmol/L predicted the development of hypoxic ischaemic encephalopathy in neonates with a sensitivity of 100% (CI: 39.8–100.0) and specificity of 88.39% (CI: 82.3–93.0). ConclusionUmbilical artery lactate correlates with adverse pregnancy outcomes and is an excellent tool for predicting adverse neonatal outcome.

The effect of dill (Anethum graveolens) seeds on labor pain and progress: A systematic review and meta-analysis

BackgroundIn recent years, there has been growing interest in exploring the potential benefits of dill (Anethum graveolens) seeds in managing labor pain and promoting labor progress. This systematic review and meta-analysis aimed to gather and analyze all available evidence on the efficacy of dill seeds in reducing labor pain and facilitating labor progress. MethodsThe databases of PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and ScienceDirect have been searched since their inception until June 20, 2023. The risk of bias for clinical trials was evaluated using the Cochrane tool and the National Institutes of Health (NIH) quality assessment tool was used for the evaluation of cohort studies. Meta-analysis was performed on the extracted data. Heterogeneity was assessed using the Chi2 and I2 index. Meta-analyses of all the data were done using RevMan 5.4. ResultsA total of 341 studies were identified through the primary search and after data reduction, finally, five articles remained for assessment. The results showed that the duration of the first stage (MD = −1.71, 95 % CI −2.94--0.48, P = 0.006), second stage (MD = −9.90, 95 % CI −15.51--4.29, p = 0.0005), and third stage (MD = −1.34, 95 % CI −2.14--0.54, p = 0.001) of labor were statistically shorter in the dill seed group, compared with that in the control group. Also, regarding pain intensity during the active stage of labor, the results indicated a favorable outcome for dill seed both overall and in the subgroup analyses of cohort and RCT studies. However, the significant finding was present only in the cohort subgroup (p < 0.00001). ConclusionUsing dill seeds in the active phase of labor in low-risk childbearing women could be an effective and low-cost intervention to reduce labor pain and accelerate labor progress. However, more high-quality clinical trials are needed to provide stronger scientific evidence.

Maternal and Perinatal outcomes in nulliparous Kashmiri women who present in latent phase versus active phase of labour

Maternal and Perinatal outcomes in nulliparous Kashmiri women who present in latent phase versus active phase of labour

Effectiveness of Labor Dance on Duration of the First Active Phase of Labor in Nulliparous Women

Prolonged labor, also known as failure to progress, occurs when the total duration of labor is more than 24 hours and if not handled properly will cause various complications for the mother and baby and even lead to death. This study aimed to determine the effectiveness of labor dance on the duration of the first active phase of labor in nulliparous women. This study was a true experimental randomized controlled trial (single blind) with a posttest only with control group design. This research was conducted from 1 February to 31 March 2023 at the Central General Hospital Prof. dr.I.G.N.G Ngoerah Denpasar and Regional General Hospital Wangaya Denpasar. 42 primigravida mothers were randomly selected according to arrival, with 21 people in the intervention and control groups. Data were analyzed using the Mann Whitney test. The average length of the first stage of labor in the experimental group was 252,62 minutes and in the control group was 355,95 minutes (p-value=0,000); effect size of 1,61 (strong effect) with a percentage of 94,5%. There was a statistically significant difference in the duration of the active phase I stage of labor between the experimental and control groups. It is hoped that health workers, especially midwives, will

Optimizing labor duration with pilates: evidence from a systematic review and meta-analysis of randomized controlled trials

BackgroundPilates has captured interest due to its possible advantages during pregnancy and childbirth. Although research indicates that Pilates may reduce labor duration, alleviate pain, and improve satisfaction with the childbirth experience, consensus on these outcomes remains elusive, underscoring the necessity for additional studies.AimThis systematic review and meta-analysis aimed to assess the impact of Pilates exercises on labor duration among pregnant women.MethodsThe online database was searched to yield the literature using the terms of ‘Pilates’, ‘childbirth’, and ‘labor duration’, and similar terms including PubMed, Clinical Key, Scopus, Web of Science, Embase, and Cochrane Database of Systematic Reviews up to June 25, 2023. Studies were considered eligible if they were randomized or clinical controlled trials (RCTs/CCTs) published in English, focusing on healthy pregnant women without exercise contraindications. The studies needed to include interventions involving Pilates or exercise movement techniques, a comparison group with no exercise, and outcomes related to labor duration, the period of the active phase, and the second stage of delivery.ResultsEleven studies, totalling 1239 participants, were included in the analysis. These studies provided high-quality evidence from exercise only RCTs/CCTs. The findings indicated a significant reduction in the active phase of labor (8 RCTs, n = 1195; Mean Difference [MD] = -56.35, 95% Confidence Interval [CI] [-89.46 to -23.25]) and overall labor duration (8 RCTs, n = 898; MD = -93.93, 95% CI [-138.34 to -49.51]) in pregnant women who engaged in Pilates exercises compared to those who did not but doesn’t affect on the duration of the second stage of labor (7 RCTs, n = 1135; MD = -0.11, 95% CI [-7.21 to 6.99]).ConclusionsWhile this review primarily addresses the effects of Pilates on healthy and low-risk pregnant women, the findings suggest a potential role for Pilates in shortening labor duration. Therefore, engaging in Pilates or similar physical activities is recommended for pregnant women to potentially facilitate a more efficient labor process.

Teknik Counter Pressure Mengurangi Intensitas Nyeri Persalinan Kala I Fase Aktif

Lower back pain is a frequent symptom during pregnancy, often worsening as the pregnancy progresses. The shifting center of gravity, hormonal changes, and increased weight gain associated with pregnancy can contribute to lower back pain and discomfort. While pharmacological interventions are sometimes necessary, there is growing interest in non-pharmacological approaches that may provide relief without potential side effects. Counter pressure is a type of massage that uses your fists to apply constant pressure to the patient's spine during compression. Anti-stress information can also be applied to the lower back in a straight or circular motion. Back compression techniques can relieve back pain during labor contractions. Objective to determine the level of labor pain in the first stage of the active phase of labor in women giving birth at the Rappang Health Center in Sidrap Regency before back massage is carried out with the counter pressure technique. To find out labor pain in the first stage of the active phase of labor in women giving birth at the Rappang Health Center, Sidrap Regency, after doing back massage using a counter pressure technique. The type of research used is pseudo- or quasy-experimental research with a Two-Group Posttest Only design. The relaxation technique obtained a mean rank of 18.25, while the group that underwent counter pressure obtained a value of 6.75. So the average pain in the group that only got the relaxation technique was higher than that done with masse counter pressure with a p value (0.000) &lt;0.05 so it can be concluded that counter pressure massage is effective in reducing pain intensity in laboring mothers. There is an influence of the Counter Pressure massage technique to reduce the intensity of labor pain during the first active phase at the Rappang Health Center, Sidrap Regency. Counter pressure could potentially be a useful technique for managing labor pain.

Rate of cervical dilatation and duration of active phase of labor among low-risk pregnant women delivering at Dodoma regional referral hospital

Background: Cervical dilation at the onset of the active phase of labor determines the rate of cervical dilatation and the duration of the active phase of labor. Identifying the abnormality toward the natural progress of the active phase of labor is important because timely intervention has been observed to be controversial among developing countries during the current practice among health care providers due to different opinion on the onset of the active phase. Thus, indication like poor progress of labor has been poorly explained in which it has become a common indication for a steady increased rate of primary cesarean section and increased new born morbidity due to birth asphyxia. Objective: This study aimed at determining the rate of cervical dilatation and duration of active phase of labor among low-risk pregnant women delivered at Dodoma Regional Referral Hospital. Methods: This is a hospital-based prospective cross-sectional study where systematic sampling method was employed in obtaining sample of 300 pregnant women. Local partograph and a semi structured questionnaire were used to record the information and findings. Data were analyzed using SPSS version 25. One sample t-test was used to determine and compare the rate and duration of active labor with the WHO standard rate. P value &lt; 0.05 was considered statistically significant. Results: The mean rate of cervical dilatation during active phase for nulliparous was 0.81cm/hour and multiparous was 0.89cm/hour respectively, which is observed to be slower than standard WHO rates. The duration of the active phase of labor was 7.6 hours for nulliparous and 6.8 hours for multiparous. Conclusion: The rate of cervical dilatation was much slower hence the longer duration of active phase in both groups than the WHO standards.

Effects of Warm Compresses on the Perineal Area During the Active Phase of Labor: A Quasi-Experimental Study.

Background A perineal tear refers to any injury to the female genitalia during labor, which can occur spontaneously or with the use of instruments. An episiotomy, a surgical procedure, is sometimes performed to enlarge the vaginal orifice to facilitate delivery. Ineffective management of labor pain can result in negative physiological and psychosocial outcomes. Objective This study aims to investigate the effect of warm compresses on the perineal area during active labor. Methods This quasi-experimental study utilized a convenience sample, dividing 80 mothers into intervention and control groups. Participants were randomly assigned to groups after meeting the inclusion criteria and signing consent forms. The inclusion criteria encompassed pregnant women aged 18 years or older with a healthy singleton pregnancy, a cephalic presentation, and a gestational age of 37 weeks or more. The women were in the active phase of the first stage of labor (6-7 cm cervical dilation). In Part I, a data collection tool was developed to gather sociodemographic data, obstetrical history, and initial assessment information. Part II assessed perineal pain using the Visual Analogue Scale. Part III collected data on the perineal status post-delivery, and Part IV gathered information about the newborns. The research was conducted in the labor unit at East Jeddah Hospital, with data collection occurring from November 2022 to February 2023. Results The results of this study revealed that the mean second-stage labor pain score was 9.73 for the control group and 8.68 for the intervention group. In the third stage of labor, the mean pain score was 4.52 for the control group and 2.75 for the intervention group. During the fourth stage of labor, the mean pain score for the control group was 2.90, compared to 1.50 for the intervention group. In terms of perineal outcomes, 17 participants (42.5%) in the intervention group had an intact perineum, compared to 11 participants (27.5%) in the control group. However, there was no significant difference in the episiotomy rate between the two groups. Conclusions The findings of this study indicate that applying a warm compress to the perineal area during active labor can enhance perineal intactness and significantly reduce perineal pain. Future research could explore the challenges nurses encounter when applying warm compresses to the perineum during labor.

The Effectiveness of Lavender Aromatherapy on Reducing Pain Intensity in The First Stage of Labor Active

Pregnant woman looks forward to the moment she gives birth in order to experience the joy she longs for. if the baby, placenta, and amniotic membranes leave the mother's uterus at term (after 37 weeks) without complications, the process is considered normal. At TPMB Siti Hapsah, S.Tr.Keb in 2024, the purpose of this study is to determine whether lavender aromatherapy reduces pain intensity during the active phase of first stage labor. The Quasy Experiment research method is used in this quantitative research design. This study used a one-group pretest-posttest design with 32 respondents. The Wilcoxon test was used to analyze the observation sheet data. Lavender aromatherapy was found to be effective at reducing pain intensity during the active phase of first stage labor at TPMB Siti Hapsah, s.Tr.Keb in 2024 because the obtained result had a significance value of 0.000, which was lower than the significance result of 5% (p-value = 0.000 0.05). During the initial active phase of labor, lavender aromatherapy is recommended for use as a complementary therapy.

Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study.

In clinical experience, occiput posterior (OP) position is associated with longer labor duration than occiput anterior (OA) position, but few studies have investigated the association between labor duration and fetal position. We aimed to compare duration of the active phase of labor in OP deliveries with OA deliveries in a contemporary population using survival methods. Secondary aims were to compare the frequencies of operative interventions, obstetric anal sphincter injuries (OASIS), postpartum hemorrhage, and newborn outcomes in OP with OA deliveries. We did a historical cohort study in three university hospitals in Norway from 2012 to 2022. Women with a single fetus in cephalic presentation, no previous cesarean section and gestational age ≥37 weeks were eligible and stratified into the first four groups of the Robson ten-group classification system (TGCS). We estimated the mean duration and calculated the hazard ratio (HR) for delivery using survival analyses. Cesarean sections and instrumental vaginal deliveries were censored. The study population comprised 112 019 women, 105 571 (94.2%) were delivered in OA and 6448 (5.8%) in OP position. The estimated mean duration of the active phase of labor was longer in women with the fetus in OP position in all four TGCS groups. The estimated duration was longer in the OP groups in analyses stratified with respect to epidural analgesia and oxytocin augmentation. The graphical abstract illustrates the probability of delivery in OP compared with OA position in merged TGCS groups 1 and 2a, as a function of time. The unadjusted HR was 0.33 (95% CI 0.31-0.36) for fetuses delivered in OP position compared with OA position in TGCS group 1, 0.25 (95% CI 0.21-0.27) in group 2a, 0.70 (95% CI 0.67-0.73) in group 3, and 0.61 (95% CI 0.55-0.67) in group 4a, respectively. Neither maternal age, gestational age, BMI nor birthweight had confounding effect. Operative delivery rates and OASIS rates were higher in OP position in all four groups. We found longer duration of the active phase of labor in women with the fetus delivered in OP position in all four TGCS groups.

Pemanfaatan Birth Ball dalam Kala Satu Persalinan untuk Mempercepat Penurunan Kepala Janin

The aim of this research plan is to determine the effectiveness of using a gym ball on lowering the head in pregnant women and speeding up the duration of labor. The method in this research is a case study using qualitative descriptive methods. The place of implementation is at PMB Rosita S.Tr Keb which is located at Citra Kencana Housing, Jl. Taman Karya No.17, Tuah Karya, Kec. Handsome, Pekanbaru City Riau 28293, Indonesia. The research was conducted on Mrs. The types of data used are primary data and secondary data. Other research results indicate that the Pelvick Rocking Exercise can speed up the first stage of the active phase of labor in multigravida mothers. This is similar to the results of research which also shows that the gym ball technique with pelvic rocking can speed up the length of labor in the first stage of the active phase by 52.61% and in terms of descent and rotation of the fetal head at the beginning of the active phase (dilatation: 3-5 cm) and the second stage.

Analyzing the Expectant Management of Redefined Active Phase of Labor (WHO 2018 Guidelines) in Nulliparous Women: A Randomized Control Trial

BACKGROUND:The World Health Organization (WHO) in their 2018 guidelines favored a noninterventional approach toward the labor process. The active phase of labor will be initiated when the cervix is 5 cm dilated and during obsoleted use of a 1 cm/hour cervical dilation rate as a diagnostic test for abnormal birth outcomes.OBJECTIVES:The aim of the study is to compare an active interventional labor management approach to a noninterventional labor management approach in nulliparous parturient women in terms of need of intervention, mode of birth, and maternofetal outcome.METHODOLOGY:This randomized control study was conducted at a rural tertiary care hospital for a period of 1.5 years. Nulliparous low-risk pregnant women presenting in latent labor were randomly allocated into two groups on the basis of cervical dilation and labor intervention. WHO 2014 guidelines with partograph were followed in group 1, and 2018 WHO guidelines with labor care guide were followed in group 2.RESULT:Both the groups were comparable with age, parity, and Bishop score at the time of admission. The incidence rates of intervention in the active first stage of labor in group 1 and group 2 were 31% and 10% with an odds ratio of 0.192 (95% confidence interval [CI] [0.079, 0.466]), and the rates of lower segment cesarean section in both the groups were 17.6% and 5.8%, respectively. The odds ratio with 95% CI for postpartum hemorrhage and neonatal intensive care unit admission in group 1 compared with group 2 was 0.313 [0.061, 1.610] and 1.057 [0.143, 7.832], respectively.CONCLUSION:This study showed that the shifting of the active first-stage threshold by 1 cm and letting labor progress at its natural pace significantly reduced the need for intervention and affected the fetal and maternal outcome positively.