Active Phase Of Labor Research Articles

A randomized controlled trial of intravenous paracetamol and intravenous tramadol for labour analgesia

Labour pain is among the most excruciating pain experienced by women. Pain relief during labour is expected to reduce maternal stress, improve maternal and perinatal outcome. Paracetamol and tramadol are easily available, inexpensive and easy administeration. The present study compared the efficacy of intravenous paracetamol and intravenous tramadol for labour analgesia. : A randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology, Christian Medical College, Ludhiana including 130 patients divided into two groups. Group A received 1000 mg of intravenous paracetamol and Group B received 100 mg of intravenous tramadol hydrochloride for labour analgesia in active phase of labour (>/= 4 cm cervical dilatation). Pain intensity was assessed by Visual Analogue scale (VAS) before; after 1 and 3 hours of drug administration. Duration of labour, mode of delivery, drug-delivery interval, maternal side effects and neonatal outcomes were also assessed.Total 130 patients with 65 in each group were included. Pain intensity was assessed and it was observed that Mean VAS score was significantly lower after 1 and 3 hours of drug administration in Group A than Group B. Mean duration of 1 stage of labour (210.79+-70.49 minutes) and mean drug delivery interval (4.34 hours) was significantly lower in Group A than Group B (246.95+/-76.09 minutes; 5.17 hours). Maternal side-effects were observed more with tramadol than paracetamol.Intravenous paracetamol is more effective labour analgesic with lesser VAS score, shorter duration of labour, drug delivery interval and with few maternal side-effects.

The Impact of the Active Stage of Labor on Estimate Fetal Weight: A Prospective Cohort Study

Objective: In the literature, there have been few data on ultrasound measurements during the active phase of labor. In this study, it was aimed to compare the accuracy of fetal weight estimation by ultrasound in terms of active phase of labor. Methods: This was a prospective cohort study at the obstetrics clinic of Esenler Gynecology and Children's Hospital in Istanbul. A total of 85 patients in active labor were included in the study. All pregnant women were evaluated for estimated fetal weight (EFW) by ultrasound evaluation, and cervical dilation and effacement measurements by pelvic examination, at most 24 hours before labor. Hadlock-4 formula was used for EFW. EFW and actual birth weight (ABW) and absolute errors of pregnant women in active labor were compared. Results: The mean EFW and ABW of the patients were 3161±482 and 3150±476 g, respectively. In terms of EFW and ABW, a finding in favor of the ultrasound was found. The error and error rates between EFW and ABW were found to be 234±191 g and 7.6±6.2, respectively. No significant difference was found in terms of these parameters (p>0.05). A significant and strong (0.80) correlation was found with estimated fetal weights and actual birth weights. Conclusion: Ultrasound can be used as a safe method to measure estimated fetal weight in the active phase of labor.

RESPECTFUL MATERNITY CARE AND THEIR POSTPARTUM EFFECTS IN WOMEN

Aim:To recognise the benefits of Respectful Maternity Care during labor and encouraging the practice of the same. Design: Cross Sectional Study Methodology : Sample Size : 100 patients Inclusion Criteria :Antenatal patients in Active Phase of Labor proceeding for Normal Vaginal Delivery Procedure : The study is a questionnaire based study. The study population will be antenatal patients admitted in a Tertiary Care Hospital. After getting informed consent , the procedure will be explained thoroughly to the participants and only the participants who are willing to take part in the study will be selected. The participants were observed in the labor ward and the post natal ward during their stay in the hospital .They were asked to answer a questionnaire postnatally . The questionnaire contains questions related to the WHO recommendations of the Respectful Maternity Care which includes topics like dignity, privacy and confidentiality, ensuring freedom from harm and mistreatment, and enabling informed choice and continuous support during labour and childbirth. This study is complelety a non invasive study. Study Duration: 4 Months Results: The study population included 100 participants admitted for labor in a tertiary care hospital where they received proper Respectful Maternity Care both antenatally and Postnatally. It was observed that women who were treated with proper RMC had more bonding with their babies and were able to breastfeed more effectively. The participants did not have common complaints of post partum depression, hesitancy to breastfeed, insomnia, lack hesitancy to Breast feed and reduced incidence of Traumatic Deliveries. Conclusion: Providing Respectful Maternity Care to antenatal patients has more positive outcomes in both antenatal and postnatal periods of a patient. It reduces common post partum ailments and promotes maternal and neonatal well being by reducing maternal and neonatal morbidity and mortality rate.

Early Congenital Syphilis: The Impact of Bad Antenatal Care

Syphilis is a systemic infectious disease caused by Troponema palidum. Syphilis is generally transmitted through sexual contact, but can also be transmitted vertically during pregnancy. Until now syphilis has become a world wide problem for pregnant women, WHO recommends syphilis tested by triple elimination (syphilis, hepatitis B, and HIV) during antenatal care for better pregnancy outcomes.21 year old female, diagnosed with primipara 32-33 weeks of gestational age active phase of labor, latent syphilis + intrauterine single live fetus with head presentation. The patient had never checked her pregnancy until the current gestational age, and only found out that she had syphilis accompanied by clinical symptoms. Birth of a baby with suspected congenital syphilis.Â

Spiritual Guidance Has an Effect on Decreasing The Level of Anxiety in Mothers During The First Stage of Labor

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

Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study.

There is limited evidence about changes in the pelvic floor during active labor. We aimed to investigate changes in hiatal dimensions during the active first stage of labor and associations with fetal descent and head position. We conducted a longitudinal, prospective cohort study at the National University Hospital of Iceland, from 2016 to 2018. Nulliparous women with spontaneous onset of labor, a single fetus in cephalic presentation, and gestational age ≥37 weeks were eligible. Fetal position was assessed with transabdominal ultrasound and fetal descent was measured with transperineal ultrasound. Three-dimensional volumes were acquired from transperineal scanning at the start of the active phase of labor and in late first stage or early second stage. The largest transverse hiatal diameter was measured in the plane of minimal hiatal dimensions. The levator urethral gap was measured as the distance between the center of the urethra and the levator insertion using tomographic ultrasound imaging. Measurements of the levator urethral gap were made in the plane of minimal hiatal dimensions and 2.5 and 5 mm cranial to this. The final study population comprised 78 women. The mean transverse hiatal diameter increased 12.4% between the two examinations, from 39.4 ± 4.1 mm (±standard deviation) at the first examination to 44.3 ± 5.8 mm at the last examination (p < 0.01). We found a moderate correlation between the transverse hiatal diameter and fetal station at the last examination (r = 0.44, r2 = 0.19; p < 0.01; regression equation y = 2.71 + 0.014x), and a weak correlation between the change in transverse hiatal diameter and change in fetal station (r = 0.29; r2 = 0.08; p = 0.01; regression equation y = 0.24 + 0.012x). Levator urethral gap increased significantly in all three planes on both the left and right sides. Head position was not associated with hiatal measurements after adjusting for fetal station. We found a significant, but only modest, increase of the hiatal dimensions during the first stage of labor. The risk of levator ani trauma will therefore be low during this stage. The change in transverse hiatal diameter was associated with fetal descent but not with head position.

The effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction: a randomized controlled study.

This study aimed to examine the effect of birth ball exercise on labor pain, delivery duration, birth comfort, and birth satisfaction. The study used a randomized controlled trial design. All 120 primiparous pregnant women were randomly assigned to the intervention (IG) and control groups (CG). After the cervical dilatation reached 4cm, the pregnant women in the IG performed birth ball exercises, adhering to the birth ball guide created by the researcher. No intervention was made in the control group other than standard midwifery care practices. The labor pain level between the groups (VAS 1-when cervical dilatation was 4cm) was similar to each other. The labor pain level (VAS 2- when cervical dilatation was 9cm) scores of the women in the IG were significantly lower than those in the CG (p < 0.05). The time between the active phase of labor until dilatation is complete and the time until the baby's head comes out after full dilatation was found to be statistically significantly shorter in the IG compared to the CG (p < 0.05). Childbirth comfort and satisfaction mean scores between the groups were found to be statistically insignificant (p > 0.05). As a result of the study, it was determined that the birth ball exercise significantly reduced labor pain and labor time. We recommend that the birth ball exercise be applied to all low-risk pregnant women because it helps fetal descent and cervical dilatation, and shortens labor pain and delivery time.

The Effect Of Upright Position On Pain Stage I Active Phase Of Labor For Primiparous Mothers At The Jumpandang Baru Health Center, Makassar

The first stage process is accompanied by pain which is a physiological process, a subjective experience of physical sensations associated with uterine contractions, dilatation and effacement of the cervix. Primiparous mothers often worry because they don't understand how to deal with childbirth. Primiparas tend to experience more anxiety, causing tension and fear so that they cannot endure the pain. The aim of this study was to find out the effect of the upright position on pain during the first stage of the active phase of labor for primiparous mothers at the Jumpandang Baru Health Center, Makassar. This type of research is quantitative experimental with a Post Test Only One Group Design approach. The population in this study were all mothers giving birth at the Jumpandang Baru Makassar Community Health Center from April to June 2023. The sample in this study was part of the population of mothers giving birth at the Jumpandang Baru Makassar Community Health Center from April to June 2023, totaling 15 people. with Purposive Sampling sampling technique.

Особливості управління болем у вагітних та породіль

Purpose - to evaluate the efficacy and adverse side effects (if any) of intravenous infusion of 1000 mg paracetamol as a method of pain relief in labour during the active phase of labour and in the postoperative period after caesarean section. Materials and methods. 43 pregnant women in the first stage of labor with active labor were studied. The selection criteria were healthy low-risk first-term mothers; aged 18-35 years; with spontaneous onset of labor at 37-40 weeks of pregnancy; the first period of labor with the opening of the cervix by 3-5 cm; one live fruit; main presentation Infulgan inf. solution was chosen as a paracetamol preparation 10 mg/ml per 100 ml. Multimodal anesthesia with a combination of the drugs Infulgan (paracetamol) and Keydex (dexketoprofen) was performed for postoperative analgesia. The pain intensity indicator was determined using the visual analog scale (VAS) - a method of subjective pain assessment. The patient marked a point on a non-graduated ruler 10 cm long, which corresponds to the degree of severity of pain. During the dynamic evaluation of changes in pain intensity, they were considered objective and significant if the true VAS value differed from the previous one by more than 1.3 cm. The comparison group consisted of 20 pregnant women in the 1st stage of labor who did not receive anesthesia at their own request. Also, a study of the effectiveness of complex multimodal anesthesia (Infulgan (paracetamol) and Keydex (dexketoprofen)) was conducted in 5 (11.6%) women in labor after delivery by caesarean section. Results. The use of intravenous paracetamol injection for analgesia during labor is an effective analgesia. There was an initial but significant decrease in the VAS score 30 minutes after Infulgan administration and a statistically significant decrease in pain after 2, 3 and 4 hours compared with the VAS score before treatment. In the group of women who did not undergo analgesia, the intensity of the pain syndrome steadily increased. In the postoperative period, after caesarean section, women underwent combined analgesia with the use of Infulgan (paracetamol) drugs as the basic component of multimodal analgesia and Keydex (dexketoprofen) as a necessary step of multimodal analgesia. The above-mentioned combination of drugs allows for Step-Up analgesia - step-by-step pain therapy. Infulgan was administered in 1 vial (1000 mg) every 6 hours by intravenous injection, and Keydex - in 1 ampoule every 8 hours by intramuscular injection. The addition of Keydex (dexketoprofen) to the analgesia provided an adequate analgesic effect and did not require the administration of opioid analgesics in the postoperative period. Conclusions. Intravenous paracetamol is an effective non-opioid drug for the relief of labor pain without any significant side effects for mother and fetus. The absence of any maternal side effects (sedation, respiratory depression, delayed gastric emptying, nausea and vomiting) or neonatal side effects (respiratory depression and decreased Apgar scores) associated with opioids allows us to recommend Infulgan for the relief of labor pain. The step-by-step Step-Up pain therapy in the postoperative period allows you to reduce the doses of each of the analgesics and reduce the frequency and side effects of the drugs. The use of Infulgan and Keydex as a method of pain management by means of Step-Up analgesia in the postoperative period in parturient women showed high efficiency, adequate tolerability and patient’s satisfaction. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Pengaruh Metode Akupresur terhadap Lamanya Persalinan: A Systematic Review

Duration of the birth process can be a factor in the emergence of complications in the mother and fetus if the fetus has not been born after 12 hours since the active phase of labor. The purpose of this systematic review is to determine the effect of the acupressure method on the duration of labor. The search for articles was carried out on the PubMed, ProQuest, ScienceDirect, and Wiley Library databases from January 2012 to January 2022 with the inclusion criteria of maternity mothers. The keywords used “Acupressure” AND “Duration of Labor”; “Acupressure” AND “Labor Duratin”. The results obtained 8 articles that match the inclusion criteria with 961 respondents. A total of 4 articles stated that acupressure could reduce the duration of the active phase of labor, 3 articles stated that acupressure could not reduce the duration of the active phase of labor, and 1 article stated that ear acupressure could reduce the duration of the active phase of labor, but body acupressure could not reduce the duration of the active phase of labor. The acupressure method can reduce the duration of the active phase of labor, so that it can be used as an alternative for women giving birth in the future. Further research can be carried out to develop research on the most effective type and duration of massage at one acupressure point to speed up the duration of labor.

Comparison of Pregnancy Outcome between 4 and 6 cm Cervical os Dilatation to Demarcate Active Phase of Labour: A Cross-Sectional Study.

This is a cross-sectional study comparing pregnancy outcomes between participants with 4 and 6 cm of cervical os dilatation at the diagnosis of the active phase of labour. It was conducted in a single tertiary centre involving low-risk singleton pregnancies at or beyond 37 weeks with spontaneous onset of labour. A total of 155 participants were recruited, 101 in group 1 (4 cm) and 54 in group 2 (6 cm). Both groups were similar in mean maternal age, mean gestational age at delivery, ethnicity, median haemoglobin level at delivery, body mass index, and parity. There were significantly more participants in group 1 who needed oxytocin augmentation (p < 0.001) for the longer mean duration (p = 0.015), use of analgesia (p < 0.001), and caesarean section rate (p = 0.002). None of the women had a postpartum haemorrhage or a third- or fourth-degree perineal tear, and none of the neonates required admission to the neonatal intensive care unit. There were significantly more nulliparas who had a caesarean section as compared to multiparas. A cervical os dilatation of 6 cm reduces the risk of caesarean section by 11% (95% CI, 0.01-0.9) and increases three times more the need for analgesia (AOR = 3.44, 95% CI, 1.2-9.4). In conclusion, the demarcation of the active phase of labour at a cervical os dilatation of 6 cm is feasible without an increase in maternal or neonatal complications.

The Impact of Maternal Position in Labor on Occiput-Posterior Position of Fetus and Pregnancy Outcomes in Pregnant Women Without Epidural Analgesia.

Fetal occiput posterior (OP) position is associated with more maternal and neonatal complications. This study aimed to investigate the effect of maternal position during labor on fetal OP position and pregnancy outcomes. This randomized clinical trial study included 180 primigravida women in labor with a single fetus and approved OP position. Participants were randomly allocated into three groups: semi-prone position (n=45), knee-chest position (n=45), and supine position (n=90). All participants were placed in the defined positions 15-30 min in labor until delivery. Data collected using Visual Analogue Scale and researcher made checklist. The ANOVA, Tukey post hoc, and the chi-square test were used to analyze. Among all participants who had OP, after intervention 16.3% in the semi-prone position, 14/3 % in the knee-chest position, and 33.7% of the control groups remained with OP at birth (X3=7/87, P=0.019). The rate of natural delivery was significantly higher in the semi-prone position and knee-chest position. The duration of active phase of labor and low back pain were significantly reduced in the semi-prone and knee-chest position compared to the control groups (P<0.05). There were no differences in the duration of the third stage of labor, APGAR score, and the rate of neonatal addition to neonatal intensive care unit, using oxytocin, and perineal tears (P>0.05). The semi-prone and knee-chest positions increase the spontaneous rotation of occiput to the anterior position, vaginal delivery rates as well as a reduction in duration of active phase of labor and low back pain after delivery.

Effect of Applying Rebozo Techniques on Pain Intensity and Anxiety among Primiparous Women during the Active Phase of Labor.

Effect of Applying Rebozo Techniques on Pain Intensity and Anxiety among Primiparous Women during the Active Phase of Labor.

Anxiety at the Onset of Active Phase of Labor and some of its Predictors in Iranian Women

Anxiety at the Onset of Active Phase of Labor and some of its Predictors in Iranian Women

Fetal Head Station in Active Phase of Labour in Nullipara: Study at a Tertiary Care Centre

Fetal Head Station in Active Phase of Labour in Nullipara: Study at a Tertiary Care Centre

Efficacy of Saffron (Crocus sativus L.) in Premenstrual Syndrome, Labor, Childbirth, and Menopause: A Systematic Review of Clinical Trials

Background: Saffron, as a medicinal plant, is widely used to treat various diseases, especially among women. Therefore, this study was conducted to review the studies on the impact of saffron on premenstrual syndrome (PMS), labor, childbirth, and menopause. Methods: This systematic review, based on the PICO process, systematically searched PubMed, Scopus, Cochrane, Embase, Web of Science, Science Direct, Google Scholar, Research Gate, and Persian databases, such as Scientific Information Database (SID) and Magiran, until February 2023. The search was based on a search strategy. Strategy search included keywords saffron OR Crocus sativus Linn. OR safranal OR crocin using AND premenstrual syndrome, postpartum depression, pregnancy anxiety, pregnancy depression, menopause, perimenopause, labor pain, childbirth, active labor phase, delivery, episiotomy, and pregnancy. Of 164 articles, 20 randomized controlled trials with a score of 3 and above based on the Jadad scale entered the study. Results: The results showed that saffron has positive effects on labor and childbirth, including improvement of Bishop’s score, labor progress, reduction of fatigue and labor pain intensity, and episiotomy healing. Additionally, it can improve mood and psychological symptoms of menopause and PMS. The results of two studies showed that saffron has an effect on postpartum depression. Conclusions: Saffron is suggested as a medicinal plant that can help improve women’s complications. However, due to the limited number of studies, it is recommended to carry out further studies without the limitations of previous studies before applying saffron in clinical medicine.

Use of Fetal Occiput – Spinal Angle at Early Active Phase of First Stage of Labour in Predicting the Labour Outcome – A CrossSectional Observational Study

Introduction: Fetal head deflexion plays an important role during the labour process and predicts the outcome of labour. Though traditionally it was assessed via digital examination, recent advancements in medicine have shown ultrasonographic parameters might be useful to measure of head flexion via fetal occiput-spine angle (OSA). Aim of this study was to evaluate its role. Method: We conducted a cross-sectional observational study on 292 uncomplicated singleton pregnant mothers without occiput posterior position. At early active phase of labour (OS= 4 – 6cm), angle between two tangential lines to the occipital bone and the vertebral body of the first cervical vertebra was measured as OSA. Labour progression and mode of delivery was monitored. Association between OSA and labour outcome along with the inter-observer difference was evaluated. Results: The mean OSA value was 133.88 ± 7.39°. The OSA measurement showed good inter-observer agreement (r = 0.99; p&lt;0.001). The mean OSA was significantly less for the group of patients who had to undergo operative delivery (instrumental and cesarean) due to labour dystocia (n=37) as compared to women who had vaginal delivery (n=251), (128 ± 7.28° vs 134.83 ± 6.97°, P&lt;0.001). The mean OSA was significantly greater for the group of patients who had a normal labour progression (n=32) as compared to women who had an abnormal progression (n=260), (134.67 ± 7.06° vs 127.47 ± 6.99°, P&lt;0.001). Sonographic assessment of deflexion using OSA was found to be an independent predictor of labour outcome according to multivariate regression analysis. OSA value less than 127.8° was associated with abnormal labour progression and operative delivery with a good sensitivity of 86.5% &amp; 85% respectively. However negative predictive value for operative delivery being 6.8%, suggests that multiple clinical parameters should be considered when the decision of caesarean section is made. Conclusion: Sonographic assessment of fetal head deflexion during early active phase can be used as reproducible, feasible screening parameter to predict labour progression and mode of delivery. Decision for operative delivery should be made using multiple clinical assessments.

The effect of mindfulness-based counseling on the childbirth experience of primiparous women: a randomized controlled clinical trial

IntroductionUnpleasant childbirth experience is considered as one of the important factors for cesarean preference. Limited studies have been investigated the impact of psycho-based interventions on the childbirth experience and the most effective counseling approach to promote a pleasant childbirth experience has not been clearly identified.ObjectiveThe present study aimed to evaluate the impact of mindfulness-based counseling on the childbirth experience of primiparous women.Methods and materialsThis randomized controlled clinical trial was conducted on 64 primiparous with gestational age of 32 to 34 weeks referred to the perinatology clinic of Al-Zahra and Taleghani educational-treatment hospital, affiliated to Tabriz University of Medical sciences, Iran. Participants were randomly assigned into the intervention and control groups. The intervention group received eight mindfulness-based counseling sessions. The intensity of childbirth pain with VAS (Visual Analog Scale) in the active phase of labor at 8 cm dilatation and the childbirth experience questionnaire were completed by interview after childbirth. Independent t-test and ANCOVA were used to compare the outcomes between the two groups.ResultsAfter controlling the effect of confounding variables, the mean score of childbirth experience in the intervention group was significantly higher than that in control group [Mean Difference (MD): 1.79, 95% CI: 2.52 to 1.07, P < 0.01]. The mean score of labor pain in the intervention group was significantly lower than that in the control group after controlling the effect of baseline score and confounding variables [MD: -2.21, 95% CL: -3.35 to -1.10, P < 0.001].ConclusionThe findings indicated that providing mindfulness-based counseling improves the childbirth experience and reduces labor pain during childbirth. However, further randomized clinical trials are needed before making a definitive conclusion.Trial registrationIranian Registry of Clinical Trials (IRCT): IRCT20171007036615N9.Date of registration: 16/03/2022, 25/12/1400.

Cervical dilatation at diagnosis of active phase of labour determines the mode of delivery and peripartum outcomes: a retrospective study in a single tertiary centre in Malaysia

BackgroundThere is an increasing trend of Caesarean section rate in Malaysia. Limited evidence demonstrated the benefits of changing the demarcation of the active phase of labour.MethodsThis was a retrospective study of 3980 singletons, term pregnancy, spontaneous labouring women between 2015 and 2019 comparing outcomes between those with cervical dilation of 4 versus 6 cm at diagnosis of the active phase of labour.ResultsA total of 3403 (85.5%) women had cervical dilatation of 4 cm, and 577 (14.5%) at 6 cm upon diagnosis of the active phase of labour. Women in 4 cm group were significantly heavier at delivery (p = 0.015) but significantly more multiparous women were in 6 cm group (p < 0.001). There were significantly fewer women in the 6 cm group who needed oxytocin infusion (p < 0.001) and epidural analgesia (p < 0.001) with significantly lower caesarean section rate (p < 0.001) done for fetal distress and poor progress (p < 0.001 both). The mean duration from diagnosis of the active phase of labour until delivery was significantly shorter in the 6 cm group (p < 0.001) with lighter mean birth weight (p = 0.019) and fewer neonates with arterial cord pH < 7.20 (p = 0.047) requiring neonatal intensive care unit admissions (p = 0.01). Multiparity (AOR = 0.488, p < 0.001), oxytocin augmentation (AOR = 0.487, p < 0.001) and active phase of labour diagnosed at 6 cm (AOR = 0.337, p < 0.001) reduced the risk of caesarean delivery. Caesarean delivery increased the risk of neonatal intensive care admission by 27% (AOR = 1.73, p < 0.001).ConclusionsActive phase of labour at 6 cm cervical dilatation is associated with reduced primary caesarean delivery rate, labour intervention, shorter labour duration and fewer neonatal complications.

SYSTEMATIC REVIEW ON MATERNAL POSITION AND MOBILITY DURING FIRST STAGE OF LABOR

This systematic review is the product of 10 top published journals. The search engines adopted in this study were PubMed, Medline, Cochrane Library, Google Scholar, and Research gate. The inclusion criteria were:1. Papers published between 2004-2020, 2. Top tier journal articles (High quality), 3. Term Mobility and rst stage of labor, duration of labor, Maternal and neonatal outcome. The present highlight is that the active phase of labor enhances the effect of gravity that helps the fetus to descend comfortably as there is adequate space to move downwards as the diameter of the pelvis expands to its maximum. The pressure on the nerve in the spine during labor is reduced and thus reducing and relieving pain. If the membranes are intact, the woman is allowed to walk about. This attitude prevents vena cava compression and encourages descent of the head. Ambulation can reduce the duration of labor, need for analgesia and improve maternal comfort. Mobilization improves frequency, strength and length of contractions, decreases the use of oxytocin to augment labor and improves oxygen supply to the fetus. It improves alignment of pelvic bones and the shape and capacity of pelvis, and optimizes the good t between fetus and pelvis. This paper shows the research gaps from different studies in the review of the literature. In this present study of systematic review, 10 recent multiple interventions based on RCTs and Non RCTs studies between 2004 to 2020 were systematically reviewed using the keywords search method. The ndings are discussed and research gaps are listed accordingly Systematic review on Mobility/Ambulation during the First Stage of Labor: