Active Phase Of Labor Research Articles

Continued Versus Discontinued Oxytocin Stimulation in the Active Phase of Labour (CONDISOX): Double Blind Randomised Controlled Trial

(Abstracted from BMJ 2021;372:n716) Oxytocin stimulation is often used to induce labor. According to 4 meta-analyses, discontinuing oxytocin stimulation once active labor has begun may have some benefits, including reducing the rate of cesarean delivery.

Intramuscular meperidine analgesia at the beginning of active phase shortens labor duration without adverse effects on obstetric lacerations

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.

Normal labor curve in twin gestation

Failure to progress is one of the leading indications for cesarean delivery in trials of labor in twin gestations. However, assessment of labor progression in twin labors is managed according to singleton labor curves. This study aimed to establish a partogram for twin deliveries that reflects normal and abnormal labor progression and customized labor curves for different subgroups of twin labors. This was a multicenter, retrospective cohort analysis of twin deliveries that were recorded in 3 tertiary medical centers between 2003 and 2017. Eligible parturients were those with twin gestations at ≥34 weeks' gestation with cephalic presentation of the presenting twin and ≥2 cervical examinations during labor. Exclusion criteria were elective cesarean delivery without a trial of labor, major fetal anomalies, and fetal demise. The study group comprised twin gestations, whereas singleton gestations comprised the control group. Statistical analysis was performed using Python 3.7.3 and SPSS, version 27. Categorical variables were analyzed using chi-square tests. Student t test and Mann-Whitney U test were applied to analyze the differences in continuous variables, as appropriate. A total of 1375 twin deliveries and 142,659 singleton deliveries met the inclusion criteria. Duration of the active phase of labor was significantly longer in twin labors than in singleton labors in both nulliparous and multiparous parturients; the 95th percentile duration was 2 hours longer in nulliparous twin labors and >3.5 hours longer in multiparous twin labors than in singleton labors. The cervical dilation progression rate was significantly slower in twin deliveries than in singleton deliveries with a mean rate in twin deliveries of 1.89 cm/h (95th percentile, 0.51 cm/h) and a mean rate of 2.48 cm/h (95th percentile, 0.73 cm/h) in singleton deliveries (P<.001). In addition, epidural use further slowed labor progression in twin deliveries. The second stage of labor was also markedly longer in twin deliveries, both in nulliparous and multiparous women (95th percentile, 3.04 vs 2.83 hours, P=.002). Twin labors are characterized by a slower progression of the active phase and second stage of labor compared with singleton labors in nulliparous and multiparous parturients. Epidural analgesia further slows labor progression in twin labors. Implementation of these findings in clinical management might lower cesarean delivery rates among cases with protracted labor in twin gestations.

ROTINAS DE UM SERVIÇO DE FISIOTERAPIA EM SAÚDE DA MULHER EM UM CENTRO OBSTÉTRICO

Over the past 20-30 years, greater emphasis has been placed on promoting and rescuing the natural and physiological characteristics of delivery and birth. In this context, assistance based on the biomechanics and physiology of childbirth through the Physiotherapist in Women\’s Health approach complements the parturient\’s global and humanized care. The purpose of this article is to show what the literature recommends in physiotherapeutic care for parturient women and to publicize the behaviors employed in the assistance group of Physiotherapy in Women\’s Health within the Pre-Childbirth and Childbirth Rooms of a maternity hospital. The target population is composed of pregnant women of habitual risk, with gestational age between 37 and 42 weeks, in active phase of labor, with fetus in cephalic presentation and with normal heartbeat frequency. Within the routine of the service, the physiotherapist performs the evaluation and reassessment, gives guidance, encourages walking and free movement, performs kinesiotherapy during labor with or without facilitators (gym ball, balance disc and others) and non-pharmacological methods (transcutaneous electrical nerve stimulation – TENS, warm bath, massage therapy, breathing and relaxation exercises, thermotherapy and positioning during labor and delivery).

The Effect of Sundanese Instrumental Music Therapy and The Provision of Spicy Drinks on Pain Intensity and Labor Duration

The pain in labor due to contractions and the process of expelling the baby cannot be avoided by the mother. One way to reduce pain intensity non-pharmacologically is music therapy and the provision of spice drinks. music therapy can reduce stress and anxiety levels, especially during childbirth, while herbal drinks derived from ginger are analgesic, as well as cinnamon and cloves, can relieve pain. The research method is “Quasi experimental pre-post test with control group design. The intervention group was Sundanese instrumental music therapy with spice drinks and the control group was only given spice drinks, which was carried out on mothers giving birth during an active phase. The population is all mothers giving birth in BPM Bogor area. The sample size of the average difference test of two paired groups is 15 respondents in each group. The results showed a decrease in labor pain in the active phase of the first stage in the intervention group with p = 0.016. This shows that there is an effect of giving music therapy and spice drinks on the intensity of labor pain as assessed by the Visual Analog Scale (VAS), and there is no significant change in the decrease in labor pain during the active phase of labor, in the control group (p&gt;0.05). There was no significant result on the length of labor with p = 0.439 (p &gt; 0.05). This means that both the control and intervention groups did not show a difference in the time/length of labor

The Effect of Labor Dance on Traumatic Childbirth Perception and Comfort: A Randomized Controlled Study.

This study aims to evaluate the effect of labor dance on traumatic childbirth perception and comfort. This is a randomized controlled experimental study. The study was conducted with 120 primiparous pregnant women (60 in experiment group, 60 in control group). The pregnant women in the experiment group performed labor dance with the researcher midwife during the active phase of labor. The researcher implemented the Childbirth Comfort Questionnaire (CCQ) when the cervical dilation was 8 cm. The Postpartum Comfort Scale (PCS) and Traumatic Childbirth Perception Scale (TCPS) were implemented almost 2 hours after giving birth. The scores of the women in the experiment group in TCPS were significantly lower than those in the control group while their mean scores in CCQ and PCS were significantly higher. Labor dance contributed to the women's more positive childbirth experiences, perceptions of childbirth as less traumatic, and increased their comfort levels.

Prediction of Perinatal Outcomes in Full-Term Fetuses Appropriates for Gestational Age by Evaluation of Cerebroplacental Ratio (Cpr) Before the Active Phase of Labor

Prediction of Perinatal Outcomes in Full-Term Fetuses Appropriates for Gestational Age by Evaluation of Cerebroplacental Ratio (Cpr) Before the Active Phase of Labor

Evaluating the Effect of Dexmedetomidine Intravenous Infusion on Labour Pain Management in Primipara Pregnant Women: A Nonrandomised Clinical Trial Study.

The pain of labour is very severe. Most women prefer painless labour to routine labour if they are aware of the methods of analgesia. The aim of this study was to evaluate the effect of dexmedetomidine intravenous infusion on labour pain management in primipara term pregnant women. In this nonrandomised clinical trial with control group, all primipara term pregnant women from August 2019 to March 2020 were included. In the intervention group, after the active phase of labour, dexmedetomidine was given according to the protocol and continued until phase 2 of labour. The control group received no intervention to reduce pain. Patients in both groups were evaluated for fetal heart rate, Apgar scores, vital signs, pain intensity, and sedation score. There were no significant differences in primary fetal heart rate, primary maternal hemodynamics, and mean Apgar scores at 1 and 5 minutes between the two groups (p > .05). There was no significant difference in the mean fetal heart rate in different stages between the two groups. Intragroup analysis in the intervention group showed that mean systolic and diastolic blood pressures were significantly decreased after drug administration but were in the normal range. The active phase of labour in the intervention group was significantly shorter than in the control group (p = 0.002). The mean Visual Analogue Scale (VAS) score after dexmedetomidine administration decreased significantly from 9.25 at baseline to 4.61 after drug administration, 3.88 during labour, and 1.88 after placental expulsion. The mean Ramsay Sedation Scale score after dexmedetomidine administration increased significantly from 1.00 at baseline to 2.05 after drug administration, 2.22 during labour, and 2.05 after placental expulsion. Based on the study's results, the administration of dexmedetomidine to manage labour pain with careful monitoring of mother and fetus is recommended.

EFFECT OF HYOSCINE-N-BUTYL BROMIDE ON CERVICAL EFFACEMENT AND DILATION DURING NORMAL LABOR

Background: Labor is a multifactorial and dynamic process which involves myometrial contraction, cervical ripening and dilation and the expulsion of the fetus and placenta in an orderly manner. Objective: To study the efficacy and safety of Hyoscine-N-butyl bromide (HNBB) on enhancement of cervical effacement and dilation during normal labor, duration of labor and mode of delivery compared to the control group. Patients and methods: This was a randomized un blinded controlled trial was conducted on pregnant women in active phase of first stage of labor from those attendant labor ward of Obstetrics and Gynecology Department at Sohag General Hospital. 200 pregnant women were recruited to this study and divided into 2 equal groups. Study group received Buscopan 20 mg diluted in 9 ml saline slowly intravenously and control group received 10 mL normal saline. Results: The mean duration of active phase of labor in the study group and control group was found to be 186 and 338 minutes respectively (p value = 0.0001). No significant difference was observed in the duration of second and third stage of labor, mode of delivery, birth weight, Apgar score and color of the liquor in both the groups. Conclusion: Administration of HNBB i.v. significantly reduced the duration time of cervical dilation in the active phase of first stage of labor, thereby reducing the total duration of labor. Hyoscine –N- butyl bromide is a new aid in the management of uncomplicated labor for a convenient shorter and safer physiological delivery making it more tolerable for the mother.

RELATIONSHIP OF THERAPEUTIC COMMUNICATION WITH ANXIETY OF FIRST ACTIVE PHASE LABOR PATIENTS IN DR. SOEKARDJO TASIKMALAYA’S HOSPITAL

Anxiety during childbirth without a solution will increase of anxiety to a high level and increase the risk of injury and will affect contractions to be hypotonic. One of the factors influence anxiety during childbirth is therapeutic communication less. Research purposes is to determine relationship of therapeutic communication with anxiety level of patients during active phase labor in dr. Soekardjo Tasikmalaya’s hospital. The research method used descriptive correlational. The population in this study are patient of first active phase on labor in delivery room. Research sample is 30 people by accidental sampling for 3 weeks. Instrument research used a standardized therapeutic communication and anxiety questionnaire. Hypothesis testing used Rank Spearman test. The results showed that the highest percentage of therapeutic communication is less category is 13 people (43.33%), The highest level of anxiety is heavy category as many as 20 people (66.66%). hypothesis test show that there is a relationship between therapeutic communication and anxiety level of patients during the first active phase labor with P-value = 0.026, the correlation coefficient value is 0.463, which means that the strength of the relationship is sufficient. Based on this research results is suggested that midwives can provide the best service to patients by improving therapeutic communication to reduce anxiety mothers in labor.

Induction of labour with oral misoprostol solution 20 microgram versus vaginal misoprostol 25 microgram 6th hourly

Induction of labour is the artificial initiation of labour before the spontaneous onset, and it is the common obstetric intervention. To compare the potency of oral misoprostol solution with vaginal misoprostol to induce labour at term. This randomized control study was carried out from July 2020 to September 2020 at Government General Hospital, Kakinada. : 80 women requiring induction were recruited in the study. The women were randomized to receive 20 micrograms of oral misoprostol solution every 2 hourly or vaginally 25 micrograms of misoprostol every 6 hourly until the labour sets in the active phase of labour. Delivery within 24 hours was the outcome in the study. Data were documented in Microsoft excel and analyzed using SPSS software. : 82.5% of women in the oral group delivered by spontaneous vaginal delivery, whereas 75% in the vaginal group. In the oral group, 37.5% of delivery occurred within 6-12 hours, 40% delivered within 12-18hours duration, whereas in the vaginal group, 12.5% delivered within 6-12hours duration, 50% delivered within 12-18hours duration. Oxytocin augmentation was required in 25% of the oral group, whereas 42.5% in the vaginal group. Meconium stained liquor was 12.5% in the oral group, whereas 20% in the vaginal group.12.5% underwent cesarean section in the oral group, 10% in the vaginal group. Compared with vaginal misoprostol, oral misoprostol solution results in shorter induction delivery interval and less oxytocin augmentation required.

Impact of analysis technique on our understanding of the natural history of labour: a simulation study.

To evaluate the discrepancy between historical and more recent descriptions of the first stage of labour by testing whether the statistical techniques used recently (repeated-measures polynomial and interval-censored regression) were appropriate for detection of periods of rapid acceleration of cervical dilatation as might occur at the time of transition from a latent to an active phase of labour. A simulation study using regression techniques. We created a simulated data set for 500000 labours with clearly defined latent and active phases using the parameters described by Friedman. Additionally, we created a data set comprising 500000 labours with a progressively increasing rate of cervical dilatation. Repeated-measures polynomial regression was used to create summary labour curves based on simulated cervical examinations. Interval-censored regression was used to create centimetre-by-centimetre estimates of rates of cervical dilatation and their 95th centiles. Labour summary curves and rates of cervical dilatation. Repeated-measures polynomial regression did not detect the rapid acceleration in cervical dilatation (i.e. acceleration phase) and overestimated lengths of labour, especially at smaller cervical dilatations. There was a two-fold overestimation in the mean rate of cervical dilatation from 4 to 6cm. Interval-censored regression overestimated median transit times, at 4- to 5-cm cervical dilatation or when cervical examinations occurred less frequently than 0.5- to 1.5-hourly. Repeated-measures polynomial regression and interval-censored regression should not be routinely used to define labour progress because they do not accurately reflect the underlying data. Repeated-measures polynomial and interval-censored regression techniques are not appropriate to model first stage of labour.

Keikutsertaan dalam kelas antenatal Dapat menurunkan intensitas nyeri persalinan Kala 1 fase aktif

The antenatal classes are means of learning activity for pregnant woman, together in a group which aimed to increase their knowledge and skills. During the labor process, there are various problems that may occur in the mother, one of which is labor pain. Efforts that can be made to reduce the pain problems are through the implementation of antenatal classes. The purpose of this study was to determine the relationship of antenatal classes and the intensity of labor pain during the active phase of labor. This is an observasional analytic study with cohort design in 33 mothers who attended the antenatal classes. The sampling tehnique that used is consecutive sampling and the data were analyzed by chi-square. As the results of data analysis on the relationship between the antenatal class and the intensity of labor pain during the first stage of active phase, the value of p = 0.000. The P value &lt; 0.05. The results of data analysis obtained that there was a relationship between the antenatal class and the intensity of the labor pain during the first stage of the active phase. Midwives are expected to be able to increase the quality of antenatal classes and can attract the interest of the community, especially pregnant woman to actively participate antenatal classes.

Considering Criteria for Active Phase Labor Management of Nulliparous Women: A Cost-Effectiveness Analysis.

The aim of the study is to evaluate differences in maternal and neonatal outcomes based on updated criteria for defining active labor at 6 cm of cervical dilation and to determine if these recommendations are cost-effective. A decision-analytic model was built using TreeAge Pro 2020 software. We included maternal outcomes of mode of delivery, endometritis, postpartum hemorrhage requiring transfusion, and death. Neonatal outcomes included rates of shoulder dystocia and permanent brachial plexus injury. Costs and quality-adjusted life years (QALYs) were included from the maternal and infant perspectives. We used a willingness-to-pay threshold of $100,000 per QALY and all model inputs were subjected to sensitivity analysis. In a theoretical cohort of 1.4 million women, a threshold of 6 cm to define active labor resulted in 373,668 fewer cesarean deliveries, 33,181 fewer cases of endometritis, 143 fewer postpartum hemorrhages requiring transfusions, and seven fewer maternal deaths when compared with a threshold of 4 cm. However, there were higher rates of adverse neonatal outcomes, including 484 more cases of shoulder dystocia and 17 more instances of permanent brachial plexus injury. Using 6 cm as the threshold resulted in lower costs and greater effectiveness, making it a dominant strategy. Multivariate sensitivity analysis demonstrated the model was robust over a wide range of assumptions. In this model, considering 6 cm of cervical dilation as the threshold for the active phase of labor compared with 4 cm was a cost-effective strategy to prevent primary cesarean deliveries, lower costs, and improve maternal outcomes, despite associated increased adverse neonatal outcomes. · Cervical dilation of 6 cm should be considered the threshold for the active phase of labor. This is a change from the prior definition of 4 cm.. · We built a theoretical model to compare outcomes and costs associated with the new active phase definition of 6 cm.. · Using a 6-cm threshold is a cost-effective strategy for decreasing primary cesarean deliveries..

Rectal versus Intramuscular Hyoscine: its Effects on Shortening the First Stage of Labor in Term Primigravid Women

Background Spasmolytic drugs such as hyoscine have been proven to enhance cervical dilatation and accelerate the stages of labor. The aim of this study was to compare rectal and intramuscular hyoscine in shortening the first stage of labor in term primigravid women. Materials and Methods: In this randomized clinical trial, 80 pregnant women were selected by convenience sampling. One group received two 10 mg rectal suppositories, whereas 2ml intramuscular (IM) hyoscine was administered for the other group, both at the onset of the active phase of labor. The two groups were compared in terms of labor stages, cervix dilatation rate, maternal blood and heart rate, Apgar score at birth and fetal heart rate. The collected data were analyzed using SPSS software (version 21.0). Results: The mean age of women in the rectal and intramuscular hyoscine groups was 24.5±3.2 and 24.65±4.45 years, respectively. The duration of first and second stages of labor was not significantly different between the two groups (P>0.05); whereas the third stage of labor in the rectal hyoscine group was significantly shorter than IM hyoscine group (P=0.001). The mean 1st and 5th min Apgar scores and the fetal heart rate after drug administration were significantly different between the two groups (P<0.05). Conclusion Hyoscine rectal suppository, which is faster absorbed and avoids gastric irritation, was significantly more effective in shortening the duration of labor in comparison to IM hyoscine, although the difference was only in the 3rd stage of labor. Therefore, it is recommended in all pregnancies for accelerating the process of labor.

Progression of the first stage of labour, in low risk nulliparas in a South Asian population: a prospective observational study

We compared the labour pattern in the active phase of labour, defined at 4 cm versus 6 cm cervical dilatation, in a South Asian population. This was a prospective observational study where 500 low risk nulliparous women were recruited. Our aim was to study, the average labour pattern curve of all parturients. Mean duration of the active phase from 4 to 10 cm was 5.12 ± 2.10 hours and from 6 to 10 cm was 2.79 ± 1.72 hours. The 95th percentile values suggests that it takes 5–6 hours to progress from 4 to 6 cm and again 5–6 hours from 6 to 10 cm. The minimum labour progression rate can be as low as 0.5 cm/hour with vaginal delivery (VD) still being achieved. The slope of labour curve steepens after 6 cm, suggesting 6 cm as the onset of the active phase. Allowing labour to continue for a longer period before 6 cm of cervical dilation may reduce the rate of unnecessary intrapartum intervention and caesarean section (CS) for labour dystocia. Impact Statement What is already known on this subject ? Friedman’s definitions of normal labour and abnormal labour are widely accepted in current obstetric practises. Friedman’s normal dilatation rate of 1 cm/h that is universally accepted is becoming questionable in our current obstetric population because of escalating rates of unnecessary labour interventions like oxytocin augmentation and CS. What the results of this study add ? The rule of 1 cm/hour of labour progression cannot be applied to every woman and inappropriate interventions should be withheld until labour progression does falls below 0.5 cm/hour. What the implications are of these findings for clinical practice and/or further research? Six centimetres rather than 4 cm of cervical dilatation is a more appropriate landmark for the start of the active phase. Allowing labour to continue for a longer period before 6 cm of cervical dilation may reduce the rate of unnecessary intrapartum interventions and CS for labour dystocia.

Can ultrasound on admission in active labor predict labor duration and a spontaneous delivery?

Identifying predictive factors for a normal outcome at admission in the labor ward would be of value for planning labor care, timing interventions, and preventing labor dystocia. Clinical assessments of fetal head station and position at the start of labor have some predictive value, but the value of ultrasound methods for this purpose has not been investigated. Studies using transperineal ultrasound before labor onset show possibilities of using these methods to predict outcomes. This study aimed to investigate whether ultrasound measurements during the first examination in the active phase of labor were associated with the duration of labor phases and the need for operative delivery. This was a secondary analysis of a prospective cohort study at Landspitali University Hospital, Reykjavík, Iceland. Nulliparous women at ≥37 weeks' gestation with a single fetus in cephalic presentation and in active spontaneous labor were eligible for the study. The recruitment period was from January 2016 to April 2018. Women were examined by a midwife on admission and included in the study if they were in active labor, which was defined as regular contractions with a fully effaced cervix, dilatation of ≥4 cm. An ultrasound examination was performed by a separate examiner within 15 minutes; both examiners were blinded to the other's results. Transabdominal and transperineal ultrasound examinations were used to assess fetal head position, cervical dilatation, and fetal head station, expressed as head-perineum distance and angle of progression. Duration of labor was estimated as the hazard ratio for spontaneous delivery using Kaplan-Meier curves and Cox regression analysis. The hazard ratios were adjusted for maternal age and body mass index. The associations between study parameters and mode of delivery were evaluated using receiver operating characteristic curves. Median times to spontaneous delivery were 490 minutes for a head-perineum distance of ≤45 mm and 682 minutes for a head-perineum distance of >45 mm (log-rank test, P=.009; adjusted hazard ratio for a shorter head-perineum distance, 1.47 [95% confidence interval, 0.83-2.60]). The median durations were 506 minutes for an angle of progression of ≥93° and 732 minutes for an angle of progression of <93° (log-rank test, P=.008; adjusted hazard ratio, 2.07 [95% confidence interval, 1.15-3.72]). The median times to delivery were 506 minutes for nonocciput posterior positions and 677 minutes for occiput posterior positions (log-rank test, P=.07; adjusted hazard ratio, 1.52 [95% confidence interval, 0.96-2.38]) Median times to delivery were 429 minutes for a dilatation of ≥6 cm and 704 minutes for a dilatation of 4 to 5 cm (log-rank test, P=.002; adjusted hazard ratio, 3.11 [95% confidence interval, 1.68-5.77]). Overall, there were 75 spontaneous deliveries; among those deliveries, 16 were instrumental vaginal deliveries (1 forceps delivery and 15 ventouse deliveries), and 8 were cesarean deliveries. Head-perineum distance and angle of progression were associated with a spontaneous delivery with area under the receiver operating characteristic curves of 0.68 (95% confidence interval, 0.55-0.80) and 0.67 (95% confidence interval, 0.55-0.80), respectively. Ultrasound measurement of cervical dilatation or position at inclusion was not significantly associated with spontaneous delivery. Ultrasound examinations showed that fetal head station and cervical dilatation were associated with the duration of labor; however, measurements of fetal head station were the variables best associated with operative deliveries.

Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia.

ObjectivesThis study aimed to compare the analgesic effect of single-dose spinal versus epidural analgesia for labor pain to verify if applying a single dose spinal analgesia is an efficient technique for labor pain management as an alternative for epidural analgesia.MethodsA total of 128 women in the active phase of labor were randomly allocated into two groups of spinal analgesia (n = 64) and epidural analgesia (n = 64). The latter received a bolus dose of 16 mL of 0.125% bupivacaine and 50 μg fentanyl and repeated 5 - 10 mL of bolus dose. The former received 2.5 mg hyperbaric bupivacaine plus 50μg fentanyl. Pain intensity was measured using the visual analog scale (VAS). The duration of analgesia, mode of delivery, the duration of labor, side effects, and maternal satisfaction were also compared.ResultsThere were no significant differences in the rate of cesarean section, duration of labor, postpartum hemorrhage, and the frequency of the fetal heart deceleration until 30 min after analgesia between the two groups. Measured pain after 30 (P = 0.0001) and 90 min (P = 0.01) was significantly lower in the spinal group than the epidural group. However, there was no significant difference between the spinal and epidural groups concerning the VAS scores at 150, 210, and 270 minutes. Maternal satisfaction was higher in the spinal group (P = 0.002). The mean duration of analgesia was longer in the spinal group than the epidural group (P = 0.0001).ConclusionsAccording to the findings, single-dose spinal analgesia, compared to epidural analgesia, is a safe, fast, and efficient technique for labor analgesia, which can be easily performed. In addition, it provides a high satisfaction level in the parturient.

Continued versus discontinued oxytocin stimulation in the active phase of labour (CONDISOX): double blind randomised controlled trial

ObjectiveTo determine whether discontinuing oxytocin stimulation in the active phase of induced labour is associated with lower caesarean section rates.DesignInternational multicentre, double blind, randomised controlled trial.SettingNine hospitals in Denmark and...

Uso de ocitocina e fatores associados em maternidades públicas

Objetivos: medir a prevalência da utilização de ocitocina no trabalho de parto e parto em maternidades públicas e identificar os fatores associados. Método: estudo transversal, realizado em duas maternidades públicas no município de Londrina, entre janeiro e junho de 2017, com 344 puérperas. Os dados foram coletados por meio da análise dos prontuários. Para análise dos fatores associados, utilizada uma regressão multivariada de Poisson, considerada p &lt;5%. Os dados foram analisados no Statistical Package for the Social Sciences 22.0. Resultados: a prevalência de uso de ocitocina foi de 50,0%. Uma variável aborto anterior (RP = 0,64; p = 0,001)apresenta como fator de risco para uso ocitocina, enquanto presença de dilatação maior ou igual a 5 cm de internação (RP = 1,36, p = 0,004) e rotura espontânea de membranas (RP = 2,33, p = 0,003) proteção para uso da ocitocina. Conclusões: os resultados demonstraram uma prevalência elevada de uso de ocitocina e a diferença estatisticamente significativa na presença de aborto anterior. Por outro lado, a presença de amniotomia espontânea e a internação de mulheres na fase ativa do trabalho de parto são fatores de proteção para uso ocitocina, evidência de comprometimento do processo fisiológico da participação.