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de Moraes EDDV, Ribeiro MS, Erbert C, Prado CADC, Moisés ECD. Impact of doula's continuous support on serotonin release in parturients: a pilot randomized clinical trial. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo27. [PMID: 38765505 PMCID: PMC11075389 DOI: 10.61622/rbgo/2024rbgo27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/24/2023] [Indexed: 05/22/2024] Open
Abstract
Objective To evaluate whether the continuous support provided by doulas influences the endogenous release of serotonin in parturients. Methods This pilot study included 24 primigravidae at term. Of these, 12 women received continuous doula support (Experimental Group), whereas the other 12 received the usual assistance without doula support (Control Group). Blood samples were collected from all the women at the active and expulsion stages of labor and at the fourth period of labor (Greenberg period) for evaluation of their serotonin levels using high-performance liquid chromatography. Results The average serotonin concentrations in the control and experimental groups were respectively 159.33 and 150.02 ng/mL at the active stage, 179.13 and 162.65 ng/mL at the expulsion stage, and 198.94 and 221.21 ng/mL at the Greenberg period. There were no statistically significant differences in serotonin concentrations between the two groups at the active and expulsion stages of labor. By contrast, within the experimental group, a significant increase in serotonin concentration was observed in the Greenberg period compared with the levels in the active and expulsion stages (p < 0.05). Conclusion The novelty of this study relies on the ability to correlate the influence of the continuous support offered by doulas with the release of serotonin in parturients, with the results suggesting that the assistance received during labor can modulate the levels of hormone release in the Greenberg period. Brazilian Registry of Clinical Trials RBR-4zjjm4h.
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Affiliation(s)
- Eleonora de Deus Vieira de Moraes
- Universidade de São PauloRibeirão Preto Medical SchoolSão PauloSPBrazilRibeirão Preto Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Mayara Segundo Ribeiro
- Universidade de São PauloRibeirão Preto Medical SchoolSão PauloSPBrazilRibeirão Preto Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Cíntia Erbert
- Women's Health Reference Center of Ribeirão PretoSão PaulostBrazilWomen's Health Reference Center of Ribeirão Preto, São Paulo, st, Brazil.
| | - Caio Antonio de Campos Prado
- Women's Health Reference Center of Ribeirão PretoSão PaulostBrazilWomen's Health Reference Center of Ribeirão Preto, São Paulo, st, Brazil.
| | - Elaine Christine Dantas Moisés
- Universidade de São PauloRibeirão Preto Medical SchoolSão PauloSPBrazilRibeirão Preto Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
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Su Y, Hoekstra SP, Leicht CA. Hot water immersion is associated with higher thermal comfort than dry passive heating for a similar rise in rectal temperature and plasma interleukin-6 concentration. Eur J Appl Physiol 2024; 124:1109-1119. [PMID: 37870668 PMCID: PMC10954860 DOI: 10.1007/s00421-023-05336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/28/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE To compare the perceptual responses and interleukin-6 (IL-6) concentration following rectal temperature-matched dry heat exposure (DH) and hot water immersion (HWI). METHODS Twelve healthy young adults (BMI 23.5 ± 3.6 kg/m2; age: 25.8 ± 5.7 years) underwent 3 trials in randomised order: DH (air temperature 68.9 °C), HWI (water temperature 37.5 °C), and thermoneutral dry exposure (CON, air temperature 27.3 °C). Blood samples to determine IL-6 plasma concentration were collected; basic affect and thermal comfort, rectal and skin temperature (Tskin) were assessed throughout the intervention. RESULTS Rectal temperature (Trec) did not differ between DH (end temperature 38.0 ± 0.4 °C) and HWI (37.9 ± 0.2 °C, P = 0.16), but was higher compared with CON (37.0 ± 0.3 °C; P ≤ 0.004). Plasma IL-6 concentration was similar after DH (pre to post: 0.8 ± 0.5 to 1.4 ± 1.5 pg·ml-1) and HWI (0.5 ± 0.2 to 0.9 ± 0.6 pg·ml-1; P = 0.46), but higher compared with CON (0.6 ± 0.5 to 0.6 ± 0.4 pg·ml-1; P = 0.01). At the end of the intervention, basic affect and thermal comfort were most unfavourable during DH (Basic affect; DH: - 0.7 ± 2.9, HWI: 0.8 ± 1.9, CON 1.9 ± 1.9, P ≤ 0.004; Thermal comfort; 2.6 ± 0.8, HWI: 1.4 ± 0.9 and CON: 0.2 ± 0.4; P ≤ 0.004). Mean Tskin was highest for DH, followed by HWI, and lowest for CON (DH: 38.5 ± 1.3 °C, HWI: 36.2 ± 0.5 °C, CON: 31.6 ± 0.7 °C, P < 0.001). CONCLUSION The IL-6 response did not differ between DH and HWI when matched for the elevation in Trec. However, thermal comfort was lower during DH compared to HWI, which may be related to the higher Tskin during DH.
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Affiliation(s)
- Yunuo Su
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Sven P Hoekstra
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Christof A Leicht
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
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Yu M, Qian H, Gan M. Comparison of different interventions for the reduction of labor pain: A systematic review and network meta-analysis. Medicine (Baltimore) 2024; 103:e37047. [PMID: 38457589 PMCID: PMC10919462 DOI: 10.1097/md.0000000000037047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/23/2023] [Accepted: 01/03/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE This systematic review and network meta-analysis were performed to compare different interventions for the reduction of labor pain. METHODS PubMed, Embase, Cochrane Library, Web of Science and ScienceDirect databases were searched for the randomized controlled trials (RCTs) meeting prespecified inclusion criteria up to January, 2023. Interventions including electrical acupoint stimulation (TEAS), epidural analgesia (EA) and control treatments. The primary outcomes included pain scores, failure rate of natural delivery, adverse events and Apgar scores. The methodological quality was assessed by the Cochrane risk of bias tool. Meta-analysis was performed by R software with gemtc package. Surfaces under the cumulative ranking curves (SUCRA) were used to rank the intervention. RESULTS Twelve studies met the inclusion criteria and were included in the network meta-analysis. TEAS (WMD -3.1, 95% CrI -3.8, -2.5) and EA (WMD -2.1, 95% CrI -2.8, -1.3) was more effective than the control in decreasing VAS. TEAS ranked first (SUCRA, 90.9%), EA ranked second (SUCRA, 74.0%) and control ranked last (SUCRA, 35.0%) for reducing VAS. For patients with labor pain, with respect to the most effective treatment for reducing failure rate of natural delivery, TEAS ranked first (SUCRA, 96.6%), EA ranked second (SUCRA, 50.4%) and control ranked last (SUCRA, 3.0%). With regard to the Apgar scores, there was high probability that TEAS ranked first (SUCRA, 80.7%), compared to control (SUCRA, 41.4%) and EA (SUCRA 27.9%). With regard to the adverse events, there was high probability that TEAS ranked first (SUCRA, 99.9%), compared to control (SUCRA, 33.2%) and EA (SUCRA 17.6%). CONCLUSION TEAS has the potential to serve as a viable alternative for women in labor, offering a simple, noninvasive, and non-pharmacological intervention that surpasses EA in terms of both analgesic effectiveness and safety for both mothers and neonates.
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Affiliation(s)
- Mengxian Yu
- Anesthesiology Department, Chongqing KangHuaZhongLian Cardiovascular Hospital, Chongqing, China
| | - Haiyan Qian
- Anesthesiology Department, Chongqing KangHuaZhongLian Cardiovascular Hospital, Chongqing, China
| | - Miao Gan
- Anesthesiology Department, Chongqing KangHuaZhongLian Cardiovascular Hospital, Chongqing, China
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Liu C, Pang L, Wang L, Zhang L, Ma D, Chen J, Nie G. A Pharmacotherapeutic Approaches for Managing Labour Pain Using Synthetic Drugs and Natural Therapies. Comb Chem High Throughput Screen 2024; 27:1276-1285. [PMID: 37464818 DOI: 10.2174/1386207326666230718144457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 07/20/2023]
Abstract
The birth of a child is a critical and potentially traumatic experience for women, entailing multiple physiological and psychosocial changes. The psychological effects of childbirth pain can have both immediate and long-term effects on the mother's health and her bond with her child. Many studies investigated the different ranges of synthetic drugs available for pain control in labour, inclusive of neuraxial analgesics, inhaled analgesics, and various opioids. The inadequate efficacy and unfavourable side effects of these synthetic drugs prevent appropriate pharmacotherapy, resulting in a quest for natural therapies for reducing labour pain. Herbal therapies (aromatherapy) using several essential oils obtained from various natural plants are another alternative that calms and manages the mind and body through aromatic compounds that have neurological and physiological effects. The review discussed the safety profile of various synthetic drugs with their dosage information and also deliberated on the mechanism and safety profile of various natural plants that are used in aromatherapy. The review also briefly highlighted the other non-pharmacological miscellaneous techniques such as TENS, hypnosis, immersion in water, acupuncture, massage, and different other tactics that aim to assist women in coping with pain in labour.
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Affiliation(s)
- Chunxiao Liu
- Department of Obstetrics, Dezhou Maternity and Child Health Care Hospital, Dezhou, 253000, China
| | - Liyan Pang
- Department of Obstetrics, Dezhou Maternity and Child Health Care Hospital, Dezhou, 253000, China
| | - Lijuan Wang
- Department of Obstetrics, Laoling People's Hospital, Dezhou City, 253600, China
| | - Lili Zhang
- Department of Obstetrics, Laoling People's Hospital, Dezhou City, 253600, China
| | - Dandan Ma
- Department of Obstetrics, Dezhou Maternity and Child Health Care Hospital, Dezhou, 253000, China
| | - Jing Chen
- Department of Obstetrics, Dezhou Maternity and Child Health Care Hospital, Dezhou, 253000, China
| | - Guimei Nie
- Department of Obstetrics and Gynecology, Jiuquan City People's Hospital, Jiuquan, Gansu, 735000, China
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Hunter AR, Heiderscheit A, Galbally M, Gravina D, Mutwalli H, Himmerich H. The Effects of Music-Based Interventions for Pain and Anxiety Management during Vaginal Labour and Caesarean Delivery: A Systematic Review and Narrative Synthesis of Randomised Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7120. [PMID: 38063550 PMCID: PMC10706633 DOI: 10.3390/ijerph20237120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/04/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023]
Abstract
Music-based interventions are not physically invasive, they usually have minimal side effects, and they are increasingly being implemented during the birthing process for pain and anxiety relief. The aim of this systematic review is to summarise and evaluate published, randomised controlled trials (RCTs) assessing the effects of music-based interventions for pain and anxiety management during vaginal labour and caesarean delivery. Following the PRISMA guidelines, a systematic search of the literature was conducted using: PsychInfo (Ovid), PubMed, and Web of Science. Studies were included in the review if they were RCTs that assessed the effects of music on pain and anxiety during vaginal and caesarean delivery by human mothers. A narrative synthesis was conducted on 28 identified studies with a total of 2835 participants. Most, but not all, of the included studies assessing music-based interventions resulted in reduced anxiety and pain during vaginal and caesarean delivery. Music as part of a comprehensive treatment strategy, participant-selected music, music coupled with another therapy, and relaxing/instrumental music was specifically useful for reducing light to moderate pain and anxiety. Music-based interventions show promising effects in mitigating pain and anxiety in women during labour. However, the long-term effects of these interventions are unclear.
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Affiliation(s)
- Amy Rose Hunter
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Mental Health Studies Programme, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AB, UK
| | - Annie Heiderscheit
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 2LZ, UK
| | - Megan Galbally
- School of Clinical Sciences, Department of Psychiatry, Monash University, Clayton, VIC 3168, Australia
| | - Davide Gravina
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Clinical and Experimental Medicine, University of Pisa, 56127 Pisa, Italy
| | - Hiba Mutwalli
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK
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Siereńska J, Sotomska Z, Madej-Łukasiak D, Wąż P, Grzybowska ME. The Use of Capacitive and Resistive Energy Transfer in Postpartum Pain Management in Women after Perineal Trauma. J Clin Med 2023; 12:6077. [PMID: 37763017 PMCID: PMC10532265 DOI: 10.3390/jcm12186077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Perineal pain occurs in 97% of women with episiotomy or first- and second-degree perineal tears on the first day after delivery. The study aimed to assess the impact of capacitive and resistive energy transfer (TECAR) on perineal pain and discomfort in the first two postpartum days. The prospective randomized double-blind study was performed with the pain and discomfort assessment using the Visual Analogue Scale at baseline and after both TECAR interventions. Characteristics data, delivery information, and the number of painkillers taken were collected. The assumed significance level was α < 0.05. The study included 121 women with a mean age of 30.7 ± 4.2 years and a median BMI of 26.1 kg/m2 (24.1; 28.9). Pain reduction at rest, when walking, and discomfort reduction when walking were significantly higher in the TECAR group compared to the sham group (p < 0.05). After the first TECAR intervention, significant reduction in all measured parameters was observed in the study group (p < 0.03), whereas in the control group, it was observed in pain and discomfort while sitting (p < 0.04). The amount of ibuprofen taken on the second day was significantly reduced in the study group compared to the first day (p = 0.004). TECAR has been shown to provide more immediate and significant reduction in perineal pain and discomfort.
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Affiliation(s)
- Joanna Siereńska
- Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Zofia Sotomska
- Independent Team of Physiotherapists, University Clinical Center, Al. Zwycięstwa 30, 80-219 Gdańsk, Poland;
| | - Dorota Madej-Łukasiak
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, University Clinical Center, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Piotr Wąż
- Department of Nuclear Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Magdalena Emilia Grzybowska
- Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
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Dastjerd F, Erfanian Arghavanian F, Sazegarnia A, Akhlaghi F, Esmaily H, Kordi M. Effect of infrared belt and hot water bag on labor pain intensity among primiparous: a randomized controlled trial. BMC Pregnancy Childbirth 2023; 23:405. [PMID: 37264341 DOI: 10.1186/s12884-023-05689-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 05/08/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Labor pain is complex, paradoxical and varied in every parturient woman. Management of labor pain has been a crucial component in maternity care. Heat therapy is one of the proposed method for labor pain relief. Infrared is one of the methods of heat therapy but there is any study in this regard. This study aimed to compare the effect of the infrared belt and hot water bag on the severity of pain in the first stage of labor among primiparous women. METHODS In this clinical trial in the first stage of labor, 20-min cycles of heat therapy were conducted at the dilations of 4-5 and 6-7 cm in the intervention group 1 by an infrared belt and in the intervention group 2 by hot water bag, respectively. The control group received routine care. The severity of the pain was measured by the short-form McGill Pain Questionnaire. RESULTS In total, 136 women consented to participate in this clinical trial study. The mean score of pain intensity was significantly lower in the two intervention groups compared to the control group (P < 0.001). The mean pain intensity was significantly lower in the infrared belt group than in the hot water bag group (P < 0.001). CONCLUSIONS Based on these findings, heat therapy with an infrared belt reduced the severity of pain in the first stage of labor. The infrared belt could be used and recommended as a safe and effective pain relief in childbirth and maternity care. TRIAL REGISTRATION This study was registered in the Iran Clinical Trial Center with the code of IRCT20190805044446N1 .
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Affiliation(s)
- Fatemeh Dastjerd
- School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Erfanian Arghavanian
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ameneh Sazegarnia
- Department of Medical Physics, Medical Physics Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farideh Akhlaghi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Kordi
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Johnson S, Kasparian NA, Cullum AS, Flanagan T, Ponting C, Kowalewski L, Main EK. Addressing Adverse Childhood and Adult Experiences During Prenatal Care. Obstet Gynecol 2023:00006250-990000000-00759. [PMID: 37141600 PMCID: PMC10184824 DOI: 10.1097/aog.0000000000005199] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/08/2022] [Indexed: 05/06/2023]
Abstract
Adverse childhood and adult experiences can affect health outcomes throughout life and across generations. The perinatal period offers a critical opportunity for obstetric clinicians to partner with patients to provide support and improve outcomes. This article draws on stakeholder input, expert opinion, and available evidence to provide recommendations for obstetric clinicians' inquiry about and response to pregnant patients' past and present adversity and trauma during prenatal care encounters. Trauma-informed care is a universal intervention that can proactively address adversity and trauma and support healing, even if a patient does not explicitly disclose past or present adversity. Inquiry about past and present adversity and trauma provides an avenue to offer support and to create individualized care plans. Preparatory steps to adopting a trauma-informed approach to prenatal care include initiating education and training for practice staff, prioritizing addressing racism and health disparities, and establishing patient safety and trust. Inquiry about adversity and trauma, as well as resilience factors, can be implemented gradually over time through open-ended questions, structured survey measures, or a combination of both techniques. A range of evidence-based educational resources, prevention and intervention programs, and community-based initiatives can be included within individualized care plans to improve perinatal health outcomes. These practices will be further developed and improved by increased clinical training and research, as well as through broad adoption of a trauma-informed approach and collaboration across specialty areas.
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Affiliation(s)
- Sara Johnson
- La Clinica de La Raza, Oakland, the California Maternal Quality Care Collaborative and the Departments of Pediatrics and Obstetrics and Gynecology, School of Medicine, Stanford University, Palo Alto, and the Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California; and the Department of Pediatrics, University of Cincinnati College of Medicine, Center for Heart Disease and Mental Health, Heart Institute, and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Yan W, Kan Z, Yin J, Ma Y. Efficacy and Safety of Transcutaneous Electrical Acupoint Stimulation (TEAS) As An Analgesic Intervention for Labor Pain: A Network Meta-analysis of Randomized Controlled Trials. Pain Ther 2023; 12:631-644. [PMID: 36934401 PMCID: PMC10199978 DOI: 10.1007/s40122-023-00496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/28/2023] [Indexed: 03/20/2023] Open
Abstract
INTRODUCTION Epidural analgesia (EA) is the most widely used intervention for the reduction of labor pain; however, it is contra-indicated for patients with spinal deformity or allergy to anesthetics and may be refused by parturients. As a noninvasive and nonnarcotic analgesic intervention, transcutaneous electrical acupoint stimulation (TEAS) has gained increasing attention in recent years. Therefore, we performed a network meta-analysis to compare the efficacy and safety of TEAS and EA as measured by visual analog scale score, the failure rate of natural delivery, adverse events, and Apgar scores. METHODS Relevant randomized controlled trials (RCTs) from four electronic databases (PubMed, EMBASE, Web of Science, and Cochrane CENTRAL) and clinical trials.gov were searched from inception until September 4, 2022. A random effects model was used during analysis, and outcomes were evaluated as standard mean difference (SMD), odds ratio (OR), and 95% confidence intervals (CrI) using STATA (version SE15.0), R (version 3.6.1), and ADDIS (version 1.16.8) software. RESULTS Ten RCTs comprising 1214 parturients were identified by screening. Six RCTs compared TEAS and controls, three compared EA and controls, and one compared TEAS and EA. No heterogeneity was found within the four outcomes. There was no significant difference in any outcomes between interventions or control treatments in terms of SMD, OR, and CrI. Combined with the highest surface under the cumulative ranking curve score, TEAS demonstrated possible better effects in the aspects of analgesic efficacy and safety under certain circumstances. CONCLUSIONS TEAS may be a potential alternative for parturients as a simple, noninvasive, and non-pharmacological intervention compared with EA in terms of analgesic efficacy and safety for mothers and neonates.
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Affiliation(s)
- Wenli Yan
- College of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Zunqi Kan
- College of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Jiahui Yin
- College of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Yuxia Ma
- Department of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Shandong, China.
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Deep breathing alleviates propofol-induced pain: a prospective, randomized, single-blind study. J Anesth 2023; 37:97-103. [PMID: 36355202 DOI: 10.1007/s00540-022-03136-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Propofol is commonly used to induce general anesthesia; however, the pain caused during propofol injection is a disadvantage. This study aimed to assess whether deep breathing attenuates propofol injection pain. METHODS This prospective, single-blind, randomized controlled study included 200 patients who were scheduled to undergo elective surgery under general anesthesia and randomly and equally divided them into group D and group C. The observers were not blinded to the pain-relieving modality, but each patient was blinded. Group D patients were requested to repeatedly take deep breaths throughout general anesthesia induction with propofol. Group C patients were requested to breathe in the usual manner. The intensity of propofol injection pain was evaluated using the visual analog scale (VAS). Furthermore, we recorded the patients' pain expressions, including grimace or hand-withdrawal, and the recalled pain measured using a VAS in the post-anesthetic care units (PACU). RESULTS Compared with patients in group C, those in group D showed significantly reduced VAS scores for propofol injection pain (20 [interquartile range (IQR): 0-48] vs. 37 [IQR 9-65], P = 0.017) and recalled pain in the PACU (16 [IQR 0-32] vs. 26 [IQR 0.5-51], P = 0.031). Further, the grimace incidence was significantly lower in group D (18%) than in group C (45%) (P < 0.001). There was no significant difference in the incidence of pain at induction, recalled pain, or hand-withdrawal. CONCLUSIONS Deep breathing could be an easy, safe, and inexpensive method for reducing pain during propofol injection.
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Natsiou K, Karaoulanis SE, Dafopoulos K, Garas A, Bonotis K. The Effect of Socioeconomic Factors on Maternal Perinatal Depressive Symptoms and the Contribution of Group Prenatal Support as a Preventive Measure. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:31-38. [PMID: 36727096 PMCID: PMC9883668 DOI: 10.1089/whr.2022.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 01/26/2023]
Abstract
Background The European and Greek financial turmoil that began in 2007 has had adverse health consequences. Stillbirth, low birth weight, infant mortality, and maternal suicide have all increased. The purpose of this study was to evaluate whether socioeconomic factors contribute to postpartum blues, and whether psychoprophylaxis with group prenatal education and support may have a beneficial effect. Materials and Methods The sample study comprised 414 pregnant women equally divided into psychoprophylaxis or standard care. There were six psychoprophylaxis sessions, with two each week lasting 2 hours each in groups of five people at the urban health center of Larissa, Greece. A questionnaire was used for data collection, including (1) closed-type questions about sociodemographic characteristics, and medical and obstetric history; (2) the Hamilton Depression Scale; (3) a Blues Questionnaire; (4) the Holmes and Rahe stressful life events scale; and (5) a scale of effects of the economic crisis. Differences between the two groups and within the groups at different time points were assessed by two-way repeated measures ANOVA tests. Results Maternity blues scores, depression scores at all time points, life stress event score, and financial difficulty score were all significantly related to each other in both groups at all time points (p < 0.01). The correlation between financial difficulties and depression/maternity blues disappeared after delivery in the intervention group. Financial difficulties, depression, and psychoprophylaxis sessions emerged as independent prognostic factors of maternity blues score, the group variable being most significantly associated with maternal blues. Conclusion Although financial status as well as depression continued to play a role, the deterrent contribution of psychoprophylaxis was the most important parameter in the final maternity blues prognostic model. The results of our study show a potential for prevention and suggest interesting hypotheses for future interventions.
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Affiliation(s)
- Konstantina Natsiou
- Midwife, Psychoprophylaxis Department, Health Center of Larissa, Larissa, Greece.,Address correspondence to: Konstantina Natsiou, MSc, Midwife, Psychoprophylaxis Department, Health Center of Larissa, Larissa, Greece, Platykampos Larissa, PC 40009, Larissa, Greece,
| | - Sokratis E. Karaoulanis
- Department of Psychiatry, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Konstantinos Dafopoulos
- Department of Obstetrics & Gynecology, Faculty of Medicine, School of Health Science, University of Thessaly, Larissa, Greece
| | - Antonis Garas
- Department of Obstetrics & Gynecology, Faculty of Medicine, School of Health Science, University of Thessaly, Larissa, Greece
| | - Konstantinos Bonotis
- Department of Psychiatry, University Hospital of Larissa, University of Thessaly, Larissa, Greece
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12
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Karatopuk S, Yarıcı F. Determining the effect of inhalation and lavender essential oil massage therapy on the severity of perceived labor pain in primiparous women: A randomized controlled trial. Explore (NY) 2023; 19:107-114. [PMID: 35987683 DOI: 10.1016/j.explore.2022.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND This research aimed to reveal the effect of lavender essence inhalation and the massage therapy applied with lavender oil on the severity of labor pain of primiparous women. METHODS This randomized controlled trial was conducted with three groups. Pregnant women participating in the study were randomly divided into control group (n=40), lavender essence inhalation group (n=44) and lavender essence massage (n=37) groups. The applications were divided in three for each phase in the first stage of labor (early, active and transition). Thereafter sacral compression and circular massage were applied for 15 minutes on the lower back (waist) region of the participants by using 2 drops of lavender oil in each phase of labor; 2 drops of lavender oil were dripped onto the palms of the participants in the inhalation group by the researcher and they were asked to inhale it for 3 minutes. Research data were collected using Personal Information Form (PIF), Visual Analogue Scale (VAS) and Postpartum Assessment of Women Survey (PAWS). RESULTS The results of the research revealed that the labor pain perceived by the women who were applied inhalation and massage therapy using lavender essential oil were milder compared to the control group (p<0.05). Another finding of the research revealed that the lavender oil inhalation gave the best results in the latent phase, however the massage therapy with lavender oil was more effective in the active and transition phases. CONCLUSION Inhalation and massage therapy applied using lavender essential oil contributed to the alleviation of perceived labor pain. For this reason, massage therapy and inhalation applications using lavender oil are recommended to be applied by midwives as a complementary method to adapt to labor pain during delivery.
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Affiliation(s)
| | - Filiz Yarıcı
- Near East University, Faculty of Healty. Near East Boulevard, ZIP: 99138 Nicosia, TRNC Mersin 10 -, Turkey.
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13
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Guzewicz P, Sierakowska M. The Role of Midwives in the Course of Natural Childbirth-Analysis of Sociodemographic and Psychosocial Factors-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15824. [PMID: 36497898 PMCID: PMC9739036 DOI: 10.3390/ijerph192315824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND An important role in the course of natural childbirth is played by midwives, who should effectively work on relieving pain. This study aims to present the opinions of midwives on non-pharmacological methods of relieving labor pain; the frequency of their use and reasons for their abandonment; and the relationship between the use of non-pharmacological methods of relieving labor pain and perceived job satisfaction, burnout, and self-efficacy of the midwife. METHODS The study was conducted online, with the participation of 135 Polish midwives working in the delivery room. The author's survey questionnaire, the Generalized Self-Efficacy Scale (GSES), the LBQ Burnout Questionnaire, and the Scale of Job Satisfaction were used. RESULTS Among the surveyed midwives, 77% use vertical positions in work with a patient giving birth. Almost all respondents consider vertical positions as an example of a non-pharmacological method of relieving labor pain; those with master's degree felt more prepared for their use (p = 0.02). The most common reason for abandoning their use was disagreement on the part of co-workers (p = 0.005). An association was observed between the use of vertical positions and the level of burnout (p = 0.001) and a significant correlation between preparation for their use and self-efficacy assessment, burnout, and job satisfaction. CONCLUSION Our research shows that it would be important to conduct additional training on the use of non-pharmacological methods to relieve labor pain and to present their benefits. In contrast to other research results, our results showed that midwives feel well prepared to use these methods; however, similar to other research, we found that they often feel disagreement from colleagues and a lack of support from their leaders. The use of vertical positions is related to burnout.
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14
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Applying a physiotherapy protocol to women during the active phase of labor improves obstetric outcomes: A randomized clinical trial. AJOG GLOBAL REPORTS 2022; 2:100125. [DOI: 10.1016/j.xagr.2022.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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15
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Women's perceptions of counselling on pain assessment and management during labour in Finland: A cross-sectional survey. Midwifery 2022; 114:103471. [DOI: 10.1016/j.midw.2022.103471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/12/2022] [Accepted: 08/26/2022] [Indexed: 11/19/2022]
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16
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Rodrigues VADS, Abreu YR, Santos CAG, Gatti AF, Murer GM, Gontijo BDR, Alves JS, Cunha TM, Azevedo VMGO, Mendonça TMS, Paro HBMS. Nonpharmacological labor pain management methods and risk of cesarean birth: A retrospective cohort study. Birth 2022; 49:464-473. [PMID: 35150169 DOI: 10.1111/birt.12617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 01/26/2021] [Accepted: 01/26/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nonpharmacological labor pain management methods (NPLPMM) are noninvasive, low-cost practices that may play a role in reducing the rates of unnecessary cesarean birth. We aimed to evaluate whether the NPLPMM is associated with the mode of birth. METHODS We conducted a retrospective cohort study with clinical records of all women admitted for birth from January 2013 to December 2017. Records of women who had spontaneous labor or received induction or augmentation of labor during hospitalization were eligible for the study. We estimated the risk ratios for cesarean birth in general linear models using the Poisson regression with adjustments for the following variables: age, ethnicity, schooling, parity, gestational age, previous cesarean birth, spontaneous labor before admission, or induction/augmentation of labor. RESULTS Within the total of 3,391 medical records, 40.1% had the use of a nonpharmacological labor pain management method registered. Cesarean rate among the study population was 44.2%. The use of NPLPMM decreased the risk of cesarean birth by 78% (OR = 0.22; 95% CI 0.19-0.26). History of a previous cesarean birth (RR = 2.63; 95% CI 2.35-2.64), the lack of use of NPLPMM (RR = 2.46; 95% CI 2.22-2.72), and primiparity (RR = 2.09; 95% CI 1.86-2.34) were the strongest risk factors for cesarean birth in the cohort. DISCUSSION The use of NPLPMM may be an effective strategy to reduce unnecessary cesarean birth. Further studies to identify the efficacy of each method may help health professionals to offer more appropriate methods at different stages of labor.
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Affiliation(s)
- Vanessa A D S Rodrigues
- Post-Graduation Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Brazil
| | - Yahn R Abreu
- Federal University of Uberlandia Medical School, Uberlandia, Brazil
| | | | - Alan F Gatti
- Federal University of Uberlandia Medical School, Uberlandia, Brazil
| | | | - Bárbara D R Gontijo
- Post-Graduation Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Brazil
| | - Juliana S Alves
- School of Physiotherapy, Federal University of Uberlandia, Uberlandia, Brazil
| | - Thayna M Cunha
- School of Physiotherapy, Federal University of Uberlandia, Uberlandia, Brazil
| | | | - Tânia M S Mendonça
- Department of Humanities in Health, Federal University of Uberlandia, Uberlandia, Brazil.,Department of Obstetrics and Gynecology, Federal University of Uberlandia, Uberlandia, Brazil
| | - Helena B M S Paro
- Department of Humanities in Health, Federal University of Uberlandia, Uberlandia, Brazil.,Department of Obstetrics and Gynecology, Federal University of Uberlandia, Uberlandia, Brazil
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17
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Guðmundsdóttir EÝ, Nieuwenhuijze M, Einarsdóttir K, Hálfdánsdóttir B, Gottfreðsdóttir H. Use of pain management in childbirth among migrant women in Iceland: A population-based cohort study. Birth 2022; 49:486-496. [PMID: 35187714 PMCID: PMC9545143 DOI: 10.1111/birt.12619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Immigration is rapidly increasing in Iceland with 13.6% of the population holding foreign citizenship in 2020. Earlier findings identified inequities in childbirth care for some women in Iceland. To gain insight into the quality of intrapartum midwifery care, migrant women's use of pain management methods during birth in Iceland was explored. METHODS A population-based cohort study including all women with a singleton birth in Iceland between 2007 and 2018, in total 48 173 births. Logistic regression analyses with odds ratios (ORs) and 95% confidence intervals (CIs) were used to investigate the relationship between migrant backgrounds defined as holding foreign citizenship and the use of pain management during birth. The main outcome measures were use of nonpharmacological and pharmacological pain management methods. RESULTS Data from 6097 migrant women were included. Migrant women had higher adjusted OR (aORs) for no use of pain management (aOR = 1.23 95% CI [1.12, 1.34]), when compared to Icelandic women. Migrant women also had lower aORs for the use of acupuncture (0.73 [0.64, 0.83]), transcutaneous electrical nerve stimulation (TENS) (0.92 [0.01, 0.67]), shower/bath (0.73 [0.66, 0.82]), aromatherapy (0.59 [0.44, 0.78]), and nitrous oxide inhalation (0.89 [0.83, 0.96]). Human Development Index (HDI) scores of countries of citizenship <0.900 were associated with lower aORs for the use of various pain management methods. CONCLUSIONS Our results suggest that being a migrant in Iceland is an important factor that limits the use of nonpharmacological pain management, especially for migrant women with citizenship from countries with HDI score <0.900.
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Affiliation(s)
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery ScienceAcademie Verloskunde MaastrichtZuydThe Netherlands,CAPHRI School for Public Health and Primary CareMaastricht UniversityMaastrichtThe Netherlands
| | - Kristjana Einarsdóttir
- Faculty of MedicineCentre of Public Health SciencesUniversity of IcelandReykjavíkIceland
| | | | - Helga Gottfreðsdóttir
- Department of MidwiferyFaculty of NursingUniversity of IcelandReykjavíkIceland,Department of Obstetrics and GynecologyWomen's ClinicLandspítali University HospitalReykjavíkIceland
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18
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Massov L, Robinson B, Rodriguez-Ramirez E, Maude R. Virtual reality is beneficial in decreasing pain in labouring women: A preliminary study. Aust N Z J Obstet Gynaecol 2022; 63:193-197. [PMID: 35880315 DOI: 10.1111/ajo.13591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 07/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Women use a range of non-pharmacological pain relief methods to reduce labour pain intensity and to help manage labour pain. AIMS The purpose of this intervention study was to determine whether virtual reality would have an effect on labour pain intensity. Virtual reality has been shown to be effective in reducing pain in other acute pain settings. MATERIALS AND METHODS This study was an intervention study in labour in a cross-over within-subjects design (Clinical Trials Registry Number: ACTRN12618001776291P). Fourteen participants reported their pain and had their heart rate and blood pressure measured during active labour while using and not using virtual reality. RESULTS There were significantly lower reported pain scores (6.14 compared to 7.61, P < 0.001) and maternal heart rate (79.86 beats per minute compared to 85.57, P = 0.033) and mean arterial pressure (88.78 mmHg compared to 92.61 mmHg, P = 0.022) were lower when using virtual reality compared to when not using virtual reality during active labour. CONCLUSION This study makes an important contribution to the field of virtual reality in labour and birth. It is consistent with other recent findings of reduced pain in labour and links decreased pain scales to heart rate and blood pressure, the physiological markers of pain.
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Affiliation(s)
- Lorna Massov
- School of Nursing, Midwifery and Health Practice, Victoria University, Wellington, New Zealand
| | - Brian Robinson
- School of Nursing, Midwifery and Health Practice, Victoria University, Wellington, New Zealand
| | | | - Robyn Maude
- School of Nursing, Midwifery and Health Practice, Victoria University, Wellington, New Zealand
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19
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Rantala A, Hakala M, Pölkki T. Women’s perceptions of the pain assessment and non-pharmacological pain relief methods used during labor: A cross-sectional survey. Eur J Midwifery 2022; 6:21. [PMID: 35515089 PMCID: PMC9006186 DOI: 10.18332/ejm/146136] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/10/2021] [Accepted: 01/26/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The use of non-pharmacological pain relief methods and pain assessment scales during labor has received limited research attention. This study aimed to describe women’s perceptions of the pain assessment and non-pharmacological pain relief methods used during labor. METHODS A descriptive, cross-sectional survey was conducted. A convenience sample of women (n=204) from one Finnish maternity ward participated in the study. Women who had given birth were asked to respond to a validated questionnaire between November 2018 and February 2019. The statistical significance of observed differences was analyzed using the chi-squared test. RESULTS Less than half (46%) of the women who gave birth at the hospital were asked to assess the intensity of their pain on a pain assessment scale. The most commonly used non-pharmacological pain relief methods were encouragement (92%), the presence of a midwife (82%), and proper breathing technique that was taught by a midwife (81%). Aqua blisters (3%), reflexology (e.g. zone magnets, 5%), and music (9%) were the least commonly used non-pharmacological methods during labor. The participants’ experiences of fear and pain were significantly associated with the implementation of pain assessment. CONCLUSIONS Women’s pain was rarely evaluated by using a certain pain assessment scale. In addition, non-pharmacological pain relief methods were inadequately used during labor. More specifically, methods that required midwives’ own personal contributions were rarely offered to the women.
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Affiliation(s)
- Arja Rantala
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Children and Women, Oulu University Hospital, Northern Ostrobothnia Hospital District, Oulu, Finland
- Oulu University of Applied Sciences, Oulu, Finland
| | - Mervi Hakala
- Department of Children and Women, Oulu University Hospital, Northern Ostrobothnia Hospital District, Oulu, Finland
| | - Tarja Pölkki
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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20
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Terfasa EA, Bulto GA, Irenso DY. Obstetric analgesia utilization in labor pain management and associated factors among obstetric care providers in the West Shewa Zone, Central Ethiopia. SAGE Open Med 2022; 10:20503121221088705. [PMID: 35342628 PMCID: PMC8943529 DOI: 10.1177/20503121221088705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/03/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: Labor pain is the worst pain that almost every woman experiences during
childbirth. Labor pain management plays a crucial role in promoting
maternal-wellbeing, contributing enormously to maternal satisfaction with
the childbirth experience and the high quality of services. Although there
have been previous studies, they have primarily been conducted at referral
or general hospitals located in urban settings. Thus, this study aimed to
assess the utilization of labor pain analgesia and associated factors among
obstetric care providers at all levels of health facilities in central
Ethiopia. Methods: A multicenter institution-based cross-sectional study design was employed
from 1 July to 30 September 2020. Simple random sampling using the lottery
method was employed to select 399 obstetric care providers. The data were
entered into Epi-data version 4.2 and analyzed using SPSS version 26.
Bivariate and multivariable logistic regression analysis were used to
identify the associated factors. The adjusted odds ratio with its 95%
confidence interval and p value ⩽ 0.05 were used to identify associated
factors. Results: The overall utilization of obstetric analgesia was 46% (95% confidence
interval: 41.2%–50.8%). Being a Midwife (adjusted odds ratio: 2.10, 95%
confidence interval: 1.27–3.47), having heard of the World Health
Organization pain ladder (adjusted odds ratio: 2.95, 95% confidence
interval: 1.73–5.01), having favorable attitude (adjusted odds ratio: 1.89,
95% confidence interval: 1.17–3.05), the expectation of obstetric care
providers about labor pain (adjusted odds ratio: 3.26, 95% confidence
interval: 1.27–8.36), having training on labor pain management (adjusted
odds ratio: 2.51, 95% confidence interval: 1.03–6.07), and presence of
chance for preference of obstetric analgesia for mothers in the facility
(adjusted odds ratio = 2.30, 95% confidence interval: 1.33–3.98) were
identified as factors significantly associated with the practice of
obstetric analgesia among obstetric care providers. Conclusion: The overall use of labor pain management methods among obstetric care
providers is low. Professional category, provider attitude, labor pain
severity expectations, and having training were found to be factors
associated with the use of obstetric analgesia. Therefore, working on
adapting and disseminating the harmonized guideline and protocols on labor
pain management and provision of training for obstetric care providers on
labor pain management techniques were recommended.
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Affiliation(s)
- Eba Abera Terfasa
- Maternity and Reproductive Health Nursing, Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | - Gizachew Abdissa Bulto
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Dereje Yadesa Irenso
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia
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The Effectiveness of Neroli Essential Oil in Relieving Anxiety and Perceived Pain in Women during Labor: A Randomized Controlled Trial. Healthcare (Basel) 2022; 10:healthcare10020366. [PMID: 35206980 PMCID: PMC8871902 DOI: 10.3390/healthcare10020366] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 12/30/2022] Open
Abstract
Childbirth is a stressful and physically painful event in a woman’s life and aromatherapy is one of the most used non-pharmacological methods that is effective in reducing anxiety and perceived pain. This randomized controlled study aimed at determining the effect of neroli oil aromatherapy on anxiety and pain intensity perception in 88 women during labor, randomly assigned to either an intervention group (n = 44) or control group (n = 44). Anxiety and perceived pain were assessed through the visual analogue scale during the latent, early, and late active phases of labor. Data analyses included the t-test, Chi-square test, and repeated measures ANOVA. Perceived pain and anxiety in the group receiving aromatherapy were significantly lower than in the control group at all stages of labor (p < 0.05). Specifically, as the labor progressed, pain and anxiety increased in all participants, but the increase was milder in the experimental group than in the control group. The multiparas showed higher average anxiety scores, but not perceived pain, than the primiparas in all phases of labor (p < 0.05). Ultimately, neroli oil aromatherapy during labor can be used as an alternative tool to relieve anxiety and perceived pain in women during all stages of labor.
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22
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The Effects of Conventional, Warm and Cold Acupressure on the Pain Perceptions and Beta-Endorphin Plasma Levels of Primiparous Women in Labor: A Randomized Controlled Trial. Explore (NY) 2022; 18:545-550. [DOI: 10.1016/j.explore.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/12/2022] [Accepted: 02/09/2022] [Indexed: 11/23/2022]
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23
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Chang CY, Gau ML, Huang CJ, Cheng HM. Effects of non-pharmacological coping strategies for reducing labor pain: A systematic review and network meta-analysis. PLoS One 2022; 17:e0261493. [PMID: 35061717 PMCID: PMC8782482 DOI: 10.1371/journal.pone.0261493] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Facilitating the childbirth process is a global issue. Many strategies have been developed to cope with labor pain and improve the delivery experience and satisfaction of pregnant women. The results of different types of medical intervention on women's expectant pain have been varied. Therefore, this systematic review was aimed at summarizing the body of evidence regarding the effects of various non-pharmacological coping strategies for reducing labor pain. METHODS The review was conducted according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched the articles published between 1989 and 2020 in six electronic databases: PubMed, MEDLINE, CINAHL, WOS, PsycARTICLES, and Airiti Library, and the reference lists of the Clinical Trial Registry. Twenty studies were identified, with eight eligible studies included in the Bayesian network meta-analysis. RESULTS Eight studies with 713 participants were included in the meta-analysis with nine different non-pharmacological strategies for reducing labor pain. The traditional meta-analysis demonstrated that the non-pharmacological coping strategies were effective in reducing labor pain. Of these interventional strategies, the ranking probabilities analysis of the network meta-analysis suggested that the Bonapace Method may be the most effective strategy in reducing labor pain, followed by acupressure. CONCLUSIONS Non-pharmacological coping strategies can reduce labor pain while maintaining an effective and satisfactory delivery experience. This systematic review, by synthesizing the body of evidence, demonstrated that non-pharmacological coping strategies are effective in reducing labor pain. Furthermore, as demonstrated in the network meta-analysis, the Bonapace Method, modulating birth pain by involving the father, is the most effective non-pharmacological intervention for reducing labor pain.
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Affiliation(s)
- Ching-Yi Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Meei-Ling Gau
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences
| | - Chi-Jung Huang
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hao-min Cheng
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Paley CA, Wittkopf PG, Jones G, Johnson MI. Does TENS Reduce the Intensity of Acute and Chronic Pain? A Comprehensive Appraisal of the Characteristics and Outcomes of 169 Reviews and 49 Meta-Analyses. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1060. [PMID: 34684097 PMCID: PMC8539683 DOI: 10.3390/medicina57101060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022]
Abstract
Background and Objectives: Uncertainty about the clinical efficacy of transcutaneous electric nerve stimulation (TENS) to alleviate pain spans half a century. There has been no attempt to synthesise the entire body of systematic review evidence. The aim of this comprehensive review was to critically appraise the characteristics and outcomes of systematic reviews evaluating the clinical efficacy of TENS for any type of acute and chronic pain in adults. Materials and Methods: We searched electronic databases for full reports of systematic reviews of studies, overviews of systematic reviews, and hybrid reviews that evaluated the efficacy of TENS for any type of clinical pain in adults. We screened reports against eligibility criteria and extracted data related to the characteristics and outcomes of the review, including effect size estimates. We conducted a descriptive analysis of extracted data. Results: We included 169 reviews consisting of eight overviews, seven hybrid reviews and 154 systematic reviews with 49 meta-analyses. A tally of authors' conclusions found a tendency toward benefits from TENS in 69/169 reviews, no benefits in 13/169 reviews, and inconclusive evidence in 87/169 reviews. Only three meta-analyses pooled sufficient data to have confidence in the effect size estimate (i.e., pooled analysis of >500 events). Lower pain intensity was found during TENS compared with control for chronic musculoskeletal pain and labour pain, and lower analgesic consumption was found post-surgery during TENS. The appraisal revealed repeated shortcomings in RCTs that have hindered confident judgements about efficacy, resulting in stagnation of evidence. Conclusions: Our appraisal reveals examples of meta-analyses with 'sufficient data' demonstrating benefit. There were no examples of meta-analyses with 'sufficient data' demonstrating no benefit. Therefore, we recommend that TENS should be considered as a treatment option. The considerable quantity of reviews with 'insufficient data' and meaningless findings have clouded the issue of efficacy. We offer solutions to these issues going forward.
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Affiliation(s)
- Carole A. Paley
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
- Research and Development Department, Airedale National Health Service (NHS) Foundation Trust, Skipton Road, Steeton, Keighley BD20 6TD, UK
| | - Priscilla G. Wittkopf
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
| | - Gareth Jones
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
| | - Mark I. Johnson
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
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Ahmadpour P, Mohammad‐Alizadeh‐Charandabi S, Doosti R, Mirghafourvand M. Use of the peanut ball during labour: A systematic review and meta-analysis. Nurs Open 2021; 8:2345-2353. [PMID: 33773071 PMCID: PMC8363404 DOI: 10.1002/nop2.844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/23/2021] [Accepted: 02/17/2021] [Indexed: 12/01/2022] Open
Abstract
AIM This study aimed to determine effectiveness of peanut ball on the duration of the stages of labour and frequency of caesarean section. DESIGN A systematic review and meta-analysis. METHOD A comprehensive electronic search was carried out with no time limit until December 2020. Collected data were analysed using software RevMan- version 5.3. Heterogeneity was assessed using I2 , T2 , and 2 . GRADE approach was used to assess the certainty of evidence. RESULTS The meta-analysis on six clinical trials with 645 participants showed no statistically significant difference between the two groups in caesarean surgery rate (RR = 0.82) and length of the first (MD = -15.64). CONCLUSIONS Therefore, further clinical trials with stronger evidence should be carried out to assess the effectiveness of peanut ball on caesarean surgery rate and length of first and second stages of labour.
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Affiliation(s)
- Parivash Ahmadpour
- Students’ Research CommitteeMidwifery DepartmentTabriz University of Medical sciencesTabrizIran
| | | | - Rana Doosti
- Students’ Research CommitteeMidwifery DepartmentTabriz University of Medical sciencesTabrizIran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research CenterTabriz University of Medical SciencesTabrizIran
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Determinants of the use of nonpharmacological analgesia for labor pain management: a national population-based study. Pain 2021; 161:2571-2580. [PMID: 32569092 DOI: 10.1097/j.pain.0000000000001956] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Besides neuraxial analgesia, nonpharmacological methods are also proposed to help women coping with pain during labor. We aimed to identify the individual and organizational factors associated with the use of nonpharmacological analgesia for labor pain management. Women who attempted vaginal delivery with labor analgesia were selected among participants included in the 2016 National Perinatal Survey, a population-based cross-sectional study. Labor analgesia was studied as neuraxial analgesia alone, nonpharmacological analgesia alone, and neuraxial and nonpharmacological analgesia combined. The associations were studied using multilevel multinomial logistic regression. Among the 9231 women included, 62.4% had neuraxial analgesia alone, 6.4% had nonpharmacological analgesia alone, and 31.2% had both. Nonpharmacological analgesia alone or combined with neuraxial analgesia were both associated with high educational level (adjusted odds ratio 1.55; 95% confidence interval [CI], 1.08-2.23 and 1.39; 95% CI, 1.18-1.63), antenatal preference to deliver without neuraxial analgesia, and public maternity unit status. Nonpharmacological analgesia alone was more frequent among multiparous women, and in maternity units with an anesthesiologist not dedicated to delivery unit (1.57; 95% CI, 1.16-2.12) and with the lowest midwife workload (2.15; 95% CI, 1.43-3.22). Neuraxial and nonpharmacological analgesia combined was negatively associated with inadequate prenatal care (0.70; 95% CI, 0.53-0.94). In France, most women who had nonpharmacological analgesia during labor used it as a complementary method to neuraxial analgesia. The use of nonpharmacological analgesia combined with neuraxial analgesia mainly depends on the woman's preference, but also on socioeconomic factors, quality of prenatal care, and care organization.
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Kaçar N, Özcan Keser N. Comparison of the effect of mechanical massage and warm mechanical massage application on perceived labor pain and childbirth experience: A randomized clinical trial. Eur J Midwifery 2021; 5:5. [PMID: 33655203 PMCID: PMC7910811 DOI: 10.18332/ejm/132883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/18/2020] [Accepted: 01/27/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Birth is undisputedly one of the most painful experiences many women endure in their lives. This study aimed to compare the effects of mechanical and warm mechanical massage application in reducing labor pain and enhancing childbirth satisfaction in primipara women. METHODS A randomized-controlled trial was conducted on 210 primipara women. Subjects were randomly divided into three groups (each group comprised 70 women) to receive either a mechanical massage, warm mechanical massage, or routine care (control). The intervention was applied twice on the lumbosacral section (relating to the back part of the pelvis between the hips) and pain level was assessed by using the visual analogue scale (VAS) before the intervention, immediately, half an hour and at 1 hour after intervention. The labor satisfaction level was assessed by using the childbirth experience questionnaire (CEQ) at 30 minutes postpartum. RESULTS Comparing the intervention groups, there were no significant differences in terms of VAS scores in admission to hospital and immediately after the first intervention, but there were significant differences in terms of VAS scores at half an hour and an hour after the first intervention, and immediately, half an hour and 1 hour after the second intervention, and at 30th min postpartum. The pain level and mean duration of labor for each intervention group were found to be lower than the control group, and childbirth satisfaction score points were higher than the control group. CONCLUSIONS Mechanical massage in the lumbosacral can be used as a reliable and effective method to reduce pain and increase childbirth satisfaction.
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Affiliation(s)
- Nükhet Kaçar
- Ministry of Health, Ankara City Hospital, Maternity Hospital, Ankara, Turkey
| | - Neslihan Özcan Keser
- Department of Midwifery, Faculty of Health Science, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Non-pharmacological labor pain management and associated factor among skilled birth attendants in Amhara Regional State health institutions, Northwest Ethiopia. Reprod Health 2020; 17:183. [PMID: 33371900 PMCID: PMC7768651 DOI: 10.1186/s12978-020-01043-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/10/2020] [Indexed: 11/17/2022] Open
Abstract
Background Healthcare providers have a responsibility to provide pain management support to women during labor. Labor pain management in low and middle income countries primarily relies on non-pharmacological methods, as there is little access to pharmacologic pain management. This study aimed to determine the utilization of non-pharmacological labor pain management (NPLPM) and associated factors among skilled birth attendants (SBAs) in Amhara Regional State health institutions, Ethiopia. Methods A cross-sectional study was conducted on 592 SBAs working in the Amhara Region, Ethiopia. A multistage sampling was used to collect data using a pretested interview-administered questionnaire. Descriptive analysis was done to characterize the study population. Logistic regression was used to model predictors of NPLPM utilization among SBAs, including age, qualifications, type of medical institution, knowledge, attitudes, and the presence of a protocol. Result Nearly forty seven percent 277(46.8%) of SBAs in the study cohort utilized NPLPM. SBAs who had adequate knowledge of NPLPM had 2.8 times increased odds of using NPLPM than SBAs who had inadequate knowledge. (95%CI 1.89–4.014). SBAs who had a positive attitude had 4.12 times increased odds of using NPLPM than SBAs with a negative attitude (95%CI 2.36, 7.2). SBAs who had labor a pain management protocol in their facility had 3.98 times increased odds of using NPLPM than those who didn’t have a labor pain management protocol (95%CI 1.83, 8.62). Conclusions The analysis pointed to a gap in the utilization of NPLPM in the Amhara Region facilities studied. Less than half of SBAs used NPLPM when caring for laboring women. Professional factors related to use of NPLPM included the age of SBAs, their attitudes, level of education, and knowledge concerning pain management. NPLPM was also significantly associated with the availability of labor pain management protocols.
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The Effect of Lavender ( Lavandula stoechas L.) on Reducing Labor Pain: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4384350. [PMID: 33224252 PMCID: PMC7673944 DOI: 10.1155/2020/4384350] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/25/2020] [Accepted: 10/22/2020] [Indexed: 11/17/2022]
Abstract
Background Labor pain is one of the most severe pains, which most of women experience. By using novel supportive methods, the labor pain can be reduced, which makes this event pleasant and delightful. Several original studies have been conducted in regard to the effect of lavender on reducing labor pain, whose results are controversial. One of the applications of meta-analysis studies is to respond to these hypotheses and remove controversies; therefore, this study aimed to determine the effect of lavender on labor pain in Iran by using meta-analysis. Methods In this study, to find published articles electronically from 2006 to 2019, the published articles in national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane Library, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) were used. Heterogenic index between studies was determined by Cochrane test (Q)c and I 2. Due to heterogeneity, the random effects model was used to estimate standardize difference of the mean score of lavender test in order to assess the labor pain between intervention and control group. Results In this meta-analysis and systematic review, finally 13 eligible articles met the inclusion criteria of the study. The sample size from original studies enrolled in the meta-analysis entered in the intervention group was 794 individuals and in the control group was 795 individuals. Mean score for pain in the control group was 7.2 ± 0.42 and in the intervention group was 5.4 ± 0.58 and this difference was statistically significant (p ≤ 0.001). Conclusion The results of this study showed that lavender can reduce labor pain, which can be considered by health policy makers and gynecologists.
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Gür EY, Apay SE. The effect of cognitive behavioral techniques using virtual reality on birth pain: a randomized controlled trial. Midwifery 2020; 91:102856. [PMID: 33478718 DOI: 10.1016/j.midw.2020.102856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/02/2020] [Accepted: 09/27/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study was conducted to investigate the effects of cognitive behavioral techniques using virtual reality on birth pain. DESING This study was planned as a double blind randomized controlled experimental study. SETTING AND PARTICIPANTS It was conducted with 273 pregnant women who were randomized between July 2016 and June 2019 at maternity hospital located in eastern Anatolia, Turkey. METHODS The study included 5 groups. (A: videos of newborn photographs with classical music, B: the video of the newborn photograph album, C: an introductory film of Turkey, D: only classical music, E: routine hospital care). The data were collected by using the "Personal Information Form", "Visual Analogue Scale", "Verbal Rating Scale" and "Virtual Reality". FINDINGS Groups show homogeneity in terms of demographic and obstetric variables. It was found that mean Visual Analogue Scale posttest mean score of the group A was 4.98 ± 1.69; group B 4.96 ± 1.72; group C 5.96 ± 2.05; group D 5.60 ± 1.63 and group E 6.38 ± 1.86. Mean Verbal Rating Scale posttest score was found that group A was 2.64 ± 0.73, group B 2.70 ± 0.87, group C 3.18 ± 1.14, group D was 2.80 ± 0.86 and group E was 3.96 ± 1.01. It was obtained that the groups' mean Visual Analogue Scale and Verbal Rating Scale posttest mean scores was statistically significant (p<0.05). CONCLUSION In this study, all cognitive techniques applied with virtual reality reduced labor pain during the active phase of labor. Especially the video of newborn photographs with classical music and newborn photograph album have been found more effective than other interventions evaluated in reducing labor pain. IMPLICATIONS FOR PRACTICE Midwives can use these techniques to reduce birth pain.
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Affiliation(s)
- Elif Yagmur Gür
- Ataturk University Health Science, Faculty Midwifery Department, Erzurum, Turkey.
| | - Serap Ejder Apay
- Ataturk University Health Science, Faculty Midwifery Department, Erzurum, Turkey
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Li Y, Li R, Yang Y, Hu Y, Xiao J, Li D. Effectiveness comparison of nonpharmacological analgesia delivery methods: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2020; 99:e22354. [PMID: 32957407 PMCID: PMC7505352 DOI: 10.1097/md.0000000000022354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Childbirth is a complex and special physiological process. Pain often accompanies the whole process of delivery. Long term pain will affect the physiological and psychological of pregnant women, and severe pain will affect the delivery process and the life of maternal and fetal. There are 2 ways to relieve delivery pain: drug analgesia and nonpharmacological analgesia. Nonpharmacological analgesia has less effect on the fetus than drug analgesia and is currently a more popular method for labor analgesia. Due to the lack of randomized trials comparing the efficacy of various nonpharmacological analgesia, it is still difficult to judge the relative efficacy. Therefore, we intend to conduct a network meta-analysis to evaluate the benefit among these nonpharmacological analgesia. METHODS According to the retrieval strategies, randomized controlled trials on nonpharmacological analgesia delivery will be obtained from China National Knowledge Infrastructure, WanFang,SinoMed, PubMed, Web of science, Embase, and Cochrane Library, regardless of publication date or language. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool will be used to evaluate the quality of the literature. The network meta-analysis will be performed in Markov Chain Monte Carlo method and carried out with Stata14 and OpenBUGS14 software. Ultimately, the evidentiary grade for the results will be evaluated. RESULTS This study will provide more reasonable choice for clinic than the effect of nonpharmacological analgesia in parturient delivery. CONCLUSION Our findings will provide references for future guidance developing and clinical decision.INPLASY registration number: INPLASY202080097.
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Affiliation(s)
- Ying Li
- Intensive Care Unit, the Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, Nanchang
| | - Runmin Li
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan
| | - Yujin Yang
- Nursing Department, the Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, Nanchang
| | - Yan Hu
- School of Nursing, Nanchang University, Jiangxi
| | - Jia Xiao
- Intensive Care Unit, the Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, Nanchang
| | - Dongying Li
- Intensive Care Unit, the Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, Nanchang
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Massage and heat application on labor pain and comfort: A quasi-randomized controlled experimental study. Explore (NY) 2020; 17:438-445. [PMID: 32828687 DOI: 10.1016/j.explore.2020.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 11/20/2022]
Abstract
AIM The aim of this study was to determine the effects of sacral massage and heat application on the perceptions of labor pain and comfort level in pregnant women. METHODS This was a quasi-randomized controlled experimental study. The data were collected under three groups in 2016: the heat application group (HAG), the massage group (MG), and the control group (CG). Each group included 30 primiparous pregnant women (range of age: 17-35) whose cervix was dilated to 4-5 cm. At 4-5 cm, 6-7 cm, and 8-9 cm cervical dilation, sacral massage was applied to MG, and sacral heat application was applied to HAG. Each group received standard midwifery care during labor. The data were collected using the Childbirth Comfort Questionnaire (CCQ) and the Numerical Rating Scale (NRS). The data were analyzed by using the Chi-square test, the Friedman test, Paired sample t-test, ANOVA, the Kruskal-Wallis test, and Wilcoxon signed-ranks test RESULTS: The mean pain score in HAG (4.56±0.67) during 4-5 cm of cervical dilation was significantly lower than those in MG (5.03±1.06) or CG (5.23±0.72) (p < 0.05). The mean pain scores in HAG (6.80±0.7) and MG (7.30±0.8) during 6-7 cm of cervical dilation were significantly lower than that in CG (7.70±0.5) (p < 0.001). Moreover, a statistically significant difference was found between the mean CCQ total scores (HAG: 31.06±3.46, CG: 27.66±3.85, p < 0.05), mean CCQ physical comfort scores (HAG: 13.16±1.89, CG: 11.03±1.80, p < 0.001), mean CCQ relief comfort level score (HAG: 11.23±1.43, CG: 10.00±2.01, p < 0.05) and mean CCQ transcendence comfort level scores (HAG: 19.83±2.37, CG: 17.66±2.15, p < 0.05) and both HAG and CG during 8-9 cm of cervical dilation. CONCLUSIONS Heat application and massage can be used as a safe and effective midwifery intervention to reduce the perception of pain in pregnant women and provide comfort during labor.
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Wadhwa Y, Alghadir AH, Iqbal ZA. Effect of Antenatal Exercises, Including Yoga, on the Course of Labor, Delivery and Pregnancy: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155274. [PMID: 32707830 PMCID: PMC7432001 DOI: 10.3390/ijerph17155274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
Background: Delivering a child is a very stressful experience for women. Pregnancy and labor entail complex events that are unique to each individual female. The management of labor pain is often done using analgesics and anesthesia, which have been shown to have some side effects. More comprehensive data are needed to provide clinically significant evidence for clinicians to confidently prescribe exercises to patients. This study was done to evaluate the effect of antenatal exercises, including yoga, on the course of labor, delivery, and pregnancy outcomes. Methods: A retrospective study was conducted among 200 primiparous subjects (aged 20-40). A questionnaire was provided to the subjects to obtain their demographic and obstetrical information 6 weeks after delivery, and their hospital records were also assessed for further details. Based on the nature and details obtained for the antenatal exercises, subjects were divided into two groups: control and exercise. Outcome measures included the need for labor induction, self-perceived pain and perceived exertion during labor, duration and nature of the delivery, newborn infant weight, maternal weight gain, history of back pain, and post-partum recovery. The total maternal weight gain (in kilograms) was calculated from weight at 6 weeks after delivery minus the weight at 12-14 weeks of gestation. Back pain during pregnancy and self-perceived labor pain were measured using a visual analog scale (VAS). The overall perceived exertion during labor was measured using an adapted Borg scale for perceived effort. Results: The subjects who followed regular antenatal exercises, including yoga, had significantly lower rates of cesarean section, lower weight gain, higher newborn infant weight, lower pain and overall discomfort during labor, lower back pain throughout pregnancy, and earlier post-partum recovery compared to those who did no specific exercises or only walked during pregnancy. Conclusions: This retrospective study showed that regular antenatal exercises, including yoga, result in better outcomes related to the course of labor, delivery, and pregnancy. These results notably indicated that pregnant women should be active throughout pregnancy and follow a supervised exercise program that includes yoga unless contraindicated. We require further large-scale prospective studies and quasi-experimental trials to confirm the observed findings.
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Affiliation(s)
| | - Ahmad H. Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Zaheen A. Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
- Correspondence: or
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Gribel GPC, Coca-Velarde LG, Moreira de Sá RA. Influence of non-pharmacological obstetric interventions on adverse outcomes of childbirth under regional analgesia. J Perinat Med 2020; 48:495-503. [PMID: 32304310 DOI: 10.1515/jpm-2019-0366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 03/13/2020] [Indexed: 11/15/2022]
Abstract
Background We examined the influence of companionship and the use of complementary therapies on adverse outcomes in parturients under regional analgesia. Methods This study is a single-center retrospective cohort of 986 term pregnant women, and it was based on data from medical records (hospitalization period: November 2012-November 2018). The women were in the active phase of labor under regional analgesia. A statistical program was used to search for an association between companionship and the use of complementary therapies with sample data. Bi- and multivariate logistic regressions based on significant associations were used to analyze the potential intervening variables in the adverse outcomes. Results Models were constructed for each of the maternal adverse outcomes. Childbirth complications were significantly associated with complementary therapies [adjusted odds ratio (AOR) = 0.42; 95% confidence interval (CI) = 0.28-0.63; P < 0.001] and companionship (AOR = 0.36; 95% CI = 0.22-0.57; P < 0.001). Prolonged maternal hospitalization was significantly associated with companionship (AOR = 0.57; 95% CI = 0.36-0.92; P < 0.05). Unplanned cesarean section showed a significant association with complementary therapies (AOR = 0.05; 95% CI = 0.01-0.47; P < 0.01). Conclusion The likelihood of childbirth complications and prolonged maternal hospitalization is reduced by companionship, whereas the likelihood of childbirth complications and cesarean section rates is reduced by the use of complementary therapies.
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Affiliation(s)
- Gisèle P C Gribel
- Department of Anesthesiology, Maternity School Hospital, Federal University of Rio de Janeiro, Rua das Laranjeiras, 180 (Laranjeiras), Rio de Janeiro, RJ 22240-003, Brazil
| | - Luis Guillermo Coca-Velarde
- Department of Statistics, Fluminense Federal University, Rua Professor Marcos Waldemar de Freitas Reis, Campus do Gragoatá (São Domingos), Niterói, RJ, Brazil
| | - Renato A Moreira de Sá
- Department of Obstetrics, Fluminense Federal University, Hospital Universitário Antônio Pedro (HUAP-UFF), Niterói, RJ, Brazil
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Manohar S, Adler HJ, Radziwon K, Salvi R. Interaction of auditory and pain pathways: Effects of stimulus intensity, hearing loss and opioid signaling. Hear Res 2020; 393:108012. [PMID: 32554129 DOI: 10.1016/j.heares.2020.108012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/24/2020] [Accepted: 05/29/2020] [Indexed: 11/19/2022]
Abstract
Moderate intensity sounds can reduce pain sensitivity (i.e., audio-analgesia) whereas intense sounds can induce aural pain, evidence of multisensory interaction between auditory and pain pathways. To explore auditory-pain pathway interactions, we used the tail-flick (TF) test to assess thermal tail-pain sensitivity by measuring the latency of a rat to remove its tail from 52 °C water. In Experiment 1, TF latencies were measured in ambient noise and broadband noise (BBN) presented from 80 to 120 dB SPL. TF latencies gradually increased from ambient to 90 dB SPL (audio-analgesia), but then declined. At 120 dB, TF latencies were significantly shorter than normal, evidence for audio-hyperalgesia near the aural threshold for pain. In Experiment II, the opioid pain pathway was modified by treating rats with a high dose of fentanyl known to induce post-treatment hyperalgesia. TF latencies in ambient noise were normal 10-days post-fentanyl. However, TF latencies became shorter than normal from 90 to 110 dB indicating that fentanyl pre-treatment had converted audio-analgesia to audio-hyperalgesia. In Experiment III, we tested the hypothesis that hearing loss could alter pain sensitivity by unilaterally exposing rats to an intense noise that induced a significant hearing loss. TF latencies in ambient noise gradually declined from 1- to 4-weeks post-exposure indicating that noise-induced hearing loss had increased pain sensitivity. Our results suggest that auditory and pain pathways interact in ways that depend on intensity, hearing loss and opioid pain signaling, results potentially relevant to pain hyperacusis.
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Affiliation(s)
- Senthilvelan Manohar
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, 14214, USA
| | - Henry J Adler
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, 14214, USA
| | - Kelly Radziwon
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, 14214, USA
| | - Richard Salvi
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, 14214, USA.
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Akin B, Saydam BK. The effect of labor dance on perceived labor pain, birth satisfaction, and neonatal outcomes. Explore (NY) 2020; 16:310-317. [PMID: 32527687 DOI: 10.1016/j.explore.2020.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This research was conducted to determine the effects of labor dance on perceived birth pain, birth satisfaction, and neonatal outcomes. DESIGN This is an experimental study. Data were collected under three groups during the active phase of labor: the dance practitioner midwife group (DPMG, comprising 40 pregnant women), the dance practitioner spouse/partner group (DPSG, comprising 40 pregnant women) and the control group (CG, comprising 80 pregnant women). SETTING This study was conducted between 1 April 2017 and 31 October 2017 in Turkey. PARTICIPANTS This study was administered on pregnant women volunteers with no risk during the active phase of labor. INTERVENTIONS During the active phase, pregnant women in DPMG danced with the midwife; pregnant women in DPSG, on the other hand, danced with their spouses/partners throughout the active phase. When vaginal dilatation reached 4 cm and 9 cm, labor pain was measured by employing the visual analog scale (VAS). In the postpartum phase, newborn babies' first, fifth, and tenth minute Apgar scores and oxygen saturation levels were measured and registered. In the first hour after delivery, the Mackey Birth Satisfaction Scale was administered. CG, on the other hand, received only the routine procedures offered in the hospital. FINDINGS The mean scores of VAS 1 and VAS 2 in DPSG and DPMG were lower than in CG. The fifth and tenth minute Apgar scores and the first, fifth, and tenth minute oxygen saturation levels of the newborns in the experimental groups, as well as the level of birth satisfaction, were significantly higher than in CG. KEY CONCLUSIONS The study showed a positive effect of labor dancing on the labor process.
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Affiliation(s)
- Bihter Akin
- Selcuk University, Faculty of Health Sciences, Midwifery Department, Konya, Turkey.
| | - Birsen Karaca Saydam
- Ege University, Faculty of Health Sciences, Midwifery Department, Izmir, Turkey.
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Cheng FK. Using Acupuncture in Labor Pain and Childbirth-Related Issues: A Narrative Review. INTERNATIONAL JOURNAL OF CHILDBIRTH 2020. [DOI: 10.1891/ijcbirth-d-19-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDLatent threats, such as prolonged labor duration and postpartum hemorrhage, endanger women and newborns during and post childbirth, which produce burdens on natal care and public health expenditures. Acupuncture, a traditional Chinese medical practice, has increasingly been used for labor delivery in various countries to cope with these problems.METHODThis narrative review searched 29 English and Chinese electronic databases. Thirty-one empirical studies, carried out in Asia, America, Africa, the Middle East, Europe, and Australia were reviewed according to inclusion and exclusion criteria.RESULTSAcupuncture is adopted with positive signs toward labor pain relief, delivery mode, labor duration, postpartum hemorrhage, APGAR score (an evaluation for a neonatal evaluation), and birth weight.DISCUSSIONWith support of earlier studies, the satisfactory effects of acupuncture on labor delivery reviewed in this research have been noted by obstetric researchers and scholars, physicians, nurses, and midwives.CONCLUSIONThis review recommends the use of acupuncture in obstetric profession with respect to maternal-related healthcare.
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Tabatabaeichehr M, Mortazavi H. The Effectiveness of Aromatherapy in the Management of Labor Pain and Anxiety: A Systematic Review. Ethiop J Health Sci 2020; 30:449-458. [PMID: 32874088 PMCID: PMC7445940 DOI: 10.4314/ejhs.v30i3.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 01/30/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience. The aim of this study was to systematically review the currently available evidences evaluating the use of aromatherapy for management of labor pain and anxiety. METHODS In a systematic review, 5 databases (PubMed, SCOPUS, Web of Science, Google Scholar and Scientific Information Database [SID]) were searched, from database inception up to December 2019. Keywords used included (aromatherapy OR ""essential oil" OR "aroma*") AND (pain OR anxiety) AND (labor OR delivery). Using the Cochrane Collaboration's 'Risk of bias' method; the risk of bias in the included studies was evaluated. RESULTS A total of 33 studies were verified to meet our inclusion criteria. Most of the included studies were conducted in Iran. Aromatherapy was applied using inhalation, massage, footbath, birthing pool, acupressure, and compress. The most popularly used essential oil in the studies was lavender (13 studies), either as a single essential oil or in a combination with other essential oils. Most of included studies confirmed the positive effect of aromatherapy in reducing labor pain and anxiety. CONCLUSION The evidences from this study suggest that aromatherapy, as a complementary and alternative modality, can help in relieving maternal anxiety and pain during labor.
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Affiliation(s)
- Mahbubeh Tabatabaeichehr
- Geriatric Care Research Center, Department of Midwifery, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hamed Mortazavi
- Geriatric Care Research Center, Department of Geriatric Nursing, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Toberna CP, Horter D, Heslin K, Forgie MM, Malloy E, Kram JJF. Dancing During Labor: Social Media Trend or Future Practice? J Patient Cent Res Rev 2020; 7:213-217. [PMID: 32377554 PMCID: PMC7197884 DOI: 10.17294/2330-0698.1723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Over the past 30 years, medical interventions in pregnancy and childbirth have increased. Some pregnant women seek less invasive and nonpharmacological options to manage discomforts during labor. While exercise during pregnancy is recommended, less is known about exercise, specifically dancing, during labor. While anecdotal evidence is supportive, little is known about the implications of exercise and dance during the first stage of labor for pain reduction and labor progression. Some movements common in dance, such as expanding hip circles that loosen and relax muscles of the pelvic floor, may be beneficial to women during labor. Available evidence suggests that dancing during the first stage of labor may decrease duration and intensity of pain and increase patient satisfaction, but further study is warranted. Ultimately, before assessing the implications of dance during labor, a feasibility study should be conducted to determine pregnant women's willingness to participate in a prospective or randomized controlled trial.
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Affiliation(s)
- Caroline P. Toberna
- Aurora Research Institute, Aurora Health Care, Milwaukee, WI
- Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
| | - Drew Horter
- Aurora Research Institute, Aurora Health Care, Milwaukee, WI
- Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
| | - Kayla Heslin
- Aurora Research Institute, Aurora Health Care, Milwaukee, WI
- Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
| | - Marie M. Forgie
- Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Obstetrics and Gynecology, Aurora Sinai Medical Center, Milwaukee, WI
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Emily Malloy
- Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Midwifery and Wellness Center, Aurora Sinai Medical Center, Milwaukee, WI
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Jessica J. F. Kram
- Aurora UW Medical Group, Aurora Health Care, Milwaukee, WI
- Center for Urban Population Health, Milwaukee, WI
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Almassinokiani F, Ahani N, Akbari P, Rahimzadeh P, Akbari H, Sharifzadeh F. Comparative Analgesic Effects of Intradermal and Subdermal Injection of Sterile Water on Active Labor Pain. Anesth Pain Med 2020; 10:e99867. [PMID: 32754431 PMCID: PMC7352939 DOI: 10.5812/aapm.99867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/30/2020] [Accepted: 04/05/2020] [Indexed: 11/28/2022] Open
Abstract
Background The labor pain is one of the factors encouraging pregnant women for cesarean section delivery. Recently, intradermal and subdermal injection of distilled water has shown to be effective in improving this pain. Objectives The present study aimed to determine which method has a greater impact on labor pain reduction. Methods In this double-blind, randomized clinical trial, 121 nulliparous women with a gestational age of ≥ 37 weeks were randomly divided into three groups: (1) 0.5 cc sterile water injection subdermally at four sacral points with insulin needles (n = 40); (2) 0.5 cc sterile water injection intradermally (n = 39); and (3) needle contact with the mentioned points as the placebo (n = 42). Before the intervention, the VAS score was measured for labor pain, and it was repeated 10, 30, 60, and 90 min after the intervention. The results were compared between the three groups. Results Before the intervention, the mean VAS pain score had no significant difference between the three groups. However, 30, 60, and 90 min after the intervention, the mean pain score was significantly lower in the intradermal and subdermal injection groups than in the control group (P = 0.001); however, the difference between the intradermal and subdermal injection groups was not significant. Conclusions The injection of distilled water by either intradermal or subdermal method was associated with a significant reduction in the pain score during labor, but there was no difference between these two methods in terms of decreasing labor pain. As sterile water injection is a safe, effective, and low-cost method, it is proposed to increase the knowledge of midwives and obstetricians about this method.
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Affiliation(s)
- Fariba Almassinokiani
- Minimally Invasive Surgery Research Center, Pain Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Nasim Ahani
- Shahid Akbarabadi Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Peyman Akbari
- Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Poupak Rahimzadeh
- Pain Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Corresponding Author: Pain Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Hossein Akbari
- Burn Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fatemeh Sharifzadeh
- Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Shahid Akbarabadi Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Nanji JA, Carvalho B. Pain management during labor and vaginal birth. Best Pract Res Clin Obstet Gynaecol 2020; 67:100-112. [PMID: 32265134 DOI: 10.1016/j.bpobgyn.2020.03.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/18/2020] [Accepted: 03/03/2020] [Indexed: 11/20/2022]
Abstract
Neuraxial analgesia provides excellent pain relief in labor. Optimizing initiation and maintenance of neuraxial labor analgesia requires different strategies. Combined spinal-epidurals or dural puncture epidurals may offer advantages over traditional epidurals. Ultrasound is useful in certain patients. Maintenance of analgesia is best achieved with a background regimen (either programmed intermittent boluses or a continuous epidural infusion) supplemented with patient-controlled epidural analgesia and using dilute local anesthetics combined with opioids such as fentanyl. Nitrous oxide and systemic opioids are also used for pain relief. Nitrous oxide may improve satisfaction despite variable effects on pain. Systemic opioids can be administered by healthcare providers or using patient-controlled analgesia. Appropriate choice of drug should take into account the stage and progression of labor, local safety protocols, and maternal and fetal/neonatal side effects. Pain in labor is complex, and women should fully participate in the decision-making process before any one modality is selected.
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Affiliation(s)
- Jalal A Nanji
- Department of Anesthesiology and Pain Medicine, University of Alberta Faculty of Medicine and Dentistry, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3V9, Canada.
| | - Brendan Carvalho
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive MC: 5640, Stanford, CA, 94305, USA.
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Khodabakhshi-koolaee A, Rooshani Koosha F, Mosalanejad L. Effect of an Accompanying Midwife on Maternal Resilience and Preferred Route of Delivery in Pregnant Women. JOURNAL OF CLINICAL AND BASIC RESEARCH 2019. [DOI: 10.29252/jcbr.3.4.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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ACOG Committee Opinion No. 766: Approaches to Limit Intervention During Labor and Birth. Obstet Gynecol 2019; 133:e164-e173. [PMID: 30575638 DOI: 10.1097/aog.0000000000003074] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that require minimal interventions and have high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted to the labor unit, a process of shared decision making is recommended to create a plan for self-care activities and coping techniques. Admission during the latent phase of labor may be necessary for a variety of reasons, including pain management or maternal fatigue. Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor. Data suggest that for women with normally progressing labor and no evidence of fetal compromise, routine amniotomy need not be undertaken unless required to facilitate monitoring. The widespread use of continuous electronic fetal monitoring has not been shown to significantly affect such outcomes as perinatal death and cerebral palsy when used for women with low-risk pregnancies. Multiple nonpharmacologic and pharmacologic techniques can be used to help women cope with labor pain. Women in spontaneously progressing labor may not require routine continuous infusion of intravenous fluids. For most women, no one position needs to be mandated or proscribed. Obstetrician-gynecologists and other obstetric care providers should be familiar with and consider using low-interventional approaches, when appropriate, for the intrapartum management of low-risk women in spontaneous labor. Birthing units should carefully consider adding family-centric interventions that are otherwise not already considered routine care and that can be safely offered, given available environmental resources and staffing models. These family-centric interventions should be provided in recognition of the value of inclusion in the birthing process for many women and their families, irrespective of delivery mode. This Committee Opinion has been revised to incorporate new evidence for risks and benefits of several of these techniques and, given the growing interest on the topic, to incorporate information on a family-centered approach to cesarean birth.
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Frey DP, Bauer ME, Bell CL, Low LK, Hassett AL, Cassidy RB, Boyer KD, Sharar SR. Virtual Reality Analgesia in Labor: The VRAIL Pilot Study-A Preliminary Randomized Controlled Trial Suggesting Benefit of Immersive Virtual Reality Analgesia in Unmedicated Laboring Women. Anesth Analg 2019; 128:e93-e96. [PMID: 31094789 DOI: 10.1213/ane.0000000000003649] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This pilot study investigated the use of virtual reality (VR) in laboring women. Twenty-seven women were observed for equivalent time during unmedicated contractions in the first stage of labor both with and without VR (order balanced and randomized). Numeric rating scale scores were collected after both study conditions. Significant decreases in sensory pain -1.5 (95% CI, -0.8 to -2.2), affective pain -2.5 (95% CI, -1.6 to -3.3), cognitive pain -3.1 (95% CI, -2.4 to -3.8), and anxiety -1.5 (95% CI, -0.8 to -2.3) were observed during VR. Results suggest that VR is a potentially effective technique for improving pain and anxiety during labor.
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Affiliation(s)
| | | | - Carrie L Bell
- Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, Michigan
| | - Lisa Kane Low
- School of Nursing, Women's Studies, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | | | | | | | - Sam R Sharar
- Department of Anesthesiology, University of Washington Harborview Medical Center, Seattle, Washington
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Ghiasi A, Bagheri L, Haseli A. A Systematic Review on the Anxiolytic Effect of Aromatherapy during the First Stage of Labor. J Caring Sci 2019; 8:51-60. [PMID: 30915314 PMCID: PMC6428160 DOI: 10.15171/jcs.2019.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/08/2018] [Indexed: 11/09/2022] Open
Abstract
Introduction: Anxiety is the most common psychological response of women to labor. The aim of the present systematic review was to evaluate and summarize the available clinical evidence on the anxiolytic effects of aromatherapy during the first stage of labor. Methods: Electronic databases including: Cochrane Library, MEDLINE/ PubMed, Scopus, CINAHL, SID, Iran Doc, ProQuest, and Google Scholar were searched up to Sep10, 2017 with the keywords of 'aroma*', 'aromatherapy', 'essential oil', 'anxiety', and ' labor '. The risk of bias in the included studies was assessed using the Cochrane Collaboration's 'Risk of bias' tool. The results were reported qualitatively. Results: A total of 14 published papers and 2 unpublished papers were retrieved which met the inclusion criteria. The studies were conducted in Iran, Egypt, Korea, and Italy. Essential oils had been used were lavender in 5 articles, rose, clary sage, geranium and frankincense in 3 articles, chamomile, bitter orange, sweet orange and peppermint in 2 articles, mandarin orange, jasmine and clove in 1 article. A majority of the studies suggested a positive effect of aromatherapy in reducing women's anxiety during the first stage of labor. Conclusion: It is recommended that aromatherapy could be applied as a complementary therapy for reducing anxiety during the first stage of labor, but methodologically rigorous studies should be conducted in this area.
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Affiliation(s)
- Ashraf Ghiasi
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Leila Bagheri
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University, Larestan Branch, Larestan, Iran
| | - Arezoo Haseli
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Setodeh S, Ghodrati F, Akbarzadeh M. The Efficacy of Father Attachment Education on the Severity of Domestic Violence in Primegravida Women. J Caring Sci 2019; 8:61-67. [PMID: 30915315 PMCID: PMC6428165 DOI: 10.15171/jcs.2019.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/30/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose: In addition to physical and psychological tension imposed on women through pregnancy, the stress of the spouses' violence can cause harmful effects on both the fetus and mother. In Iran, there are limited data on this subject. Thus, learning attachment skills may be effective in reducing adaptation and domestic violence. This study aimed to investigate the efficacy of paternal attachment on the severity of domestic violence in primgravida women. Methods: This quasi-experiment research was conducted on 150 pregnant women who were eligible and selected through simple convenience sampling. In the intervention group, four 90-minute training sessions were designed on father attachment, while the control group received routine prenatal care. A violence questionnaire was completed both before and after the intervention (36-38 weeks of pregnancy) in both case and control groups. Data analysis was done in SPSS software, using paired t-test and independent t-test. Results: According to the results of an independent t-test, there was no significant difference in psychological violence, physical violence, and economic violence. However, there was a significant change in social violence, sexual violence, and overall violence score. Conclusion: Training the fathers on behavior of domestic violence and its skills leads to reduced social and sexual violence. Therefore, it seems necessary to include education for the fathers in prenatal care.
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Affiliation(s)
- Sara Setodeh
- Department of Midwifery, Student Research Center, Nursing and Midwifery Faculty, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Ghodrati
- Department of Theology, Faculty of Humanities Science College, Yasouj University, Yasouj, Iran
| | - Marzieh Akbarzadeh
- Department of Midwifery, Maternal-Fetal Medicine Research Center, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Báez Suárez A, Martín Castillo E, García Andújar J, García Hernández JÁ, Quintana Montesdeoca MP, Loro Ferrer JF. Evaluation of the effectiveness of transcutaneous nerve stimulation during labor in breech presentation: a case series. J Matern Fetal Neonatal Med 2019; 34:24-30. [PMID: 30654675 DOI: 10.1080/14767058.2019.1572110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To analyze the effectiveness of pain relief with transcutaneous electrical nerve stimulation (TENS) dispositive during labor in breech vaginal delivery and also to describe its tolerance and satisfaction.Design: A randomized, double-blind, and placebo-controlled trial was conducted.Setting: Labor room of Complejo Hospitalario Universitario Insular-Materno Infantil (Spain).Participants: Ten women who met the inclusion criteria of the clinical trial and also had a fetus breech presentation were randomly assigned to three groups.Interventions: A portable TENS, Cefar Rehab 2pro®, unit was used to apply the experimental intervention, with different doses in the three groups in women during labor. The device intensity (amplitude) was individually adjusted to each participant's maximum sensory level. The pain was evaluated with visual analog scale (VAS). COMFORTS scale was used to measure women's satisfaction.Results: A significant association of VAS was detected depending on the type of TENS over time. Active TENS2 was the only group that obtained an improvement with clinically significant results. In connection with women satisfaction, active TENS2 group was also the group that presented higher values.Conclusions: We can recommend the use of TENS dispositive to relieve pain during labor, also in those women with breech presentation.
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Affiliation(s)
- Aníbal Báez Suárez
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria Facultad de Ciencias de la Salud, Las Palmas de Gran Canaria, Spain
| | - Estela Martín Castillo
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria Facultad de Ciencias de la Salud, Las Palmas de Gran Canaria, Spain
| | - Josué García Andújar
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria Facultad de Ciencias de la Salud, Las Palmas de Gran Canaria, Spain
| | - José Ángel García Hernández
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria Facultad de Ciencias de la Salud, Las Palmas de Gran Canaria, Spain
| | - M Pino Quintana Montesdeoca
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria Facultad de Ciencias de la Salud, Las Palmas de Gran Canaria, Spain
| | - Juan Francisco Loro Ferrer
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria Facultad de Ciencias de la Salud, Las Palmas de Gran Canaria, Spain
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Effect of expressıve touchıng on labour paın and maternal satısfactıon: A randomized controlled trial. Complement Ther Clin Pract 2019; 34:268-274. [PMID: 30712737 DOI: 10.1016/j.ctcp.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/20/2018] [Accepted: 01/03/2019] [Indexed: 11/21/2022]
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Lee N, Jomeen J, Mårtensson LB, Emery V, Kildea S. Knowledge and use of sterile water injections amongst midwives in the United Kingdom: A cross-sectional study. Midwifery 2019; 68:9-14. [DOI: 10.1016/j.midw.2018.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 09/07/2018] [Accepted: 10/02/2018] [Indexed: 11/15/2022]
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50
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Báez-Suárez A, Martín-Castillo E, García-Andújar J, García-Hernández JÁ, Quintana-Montesdeoca MP, Loro-Ferrer JF. Evaluation of different doses of transcutaneous nerve stimulation for pain relief during labour: a randomized controlled trial. Trials 2018; 19:652. [PMID: 30477529 PMCID: PMC6258317 DOI: 10.1186/s13063-018-3036-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 11/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pain during labour is one of the most intense pain that women may experience in their lifetime. There are several non-pharmacological analgesic methods to relieve pain during labour, among them transcutaneous electrical nerve stimulation (TENS). TENS is a low-frequency electrotherapy technique, analgesic type, generally used in musculoskeletal pathology, but it has also come to be used as an alternative treatment during labour. The purpose of this study is to investigate the pain-relieving effect of a TENS application during labour and to find out the most effective dose. METHODS This study is a randomized, double-blind, placebo-controlled trial. TENS therapy was initiated at the beginning of the active phase of labour. Participants were randomly assigned to three groups (21 per group: two active TENS and one placebo). Active TENS 1 intervention consisted in a constant frequency of 100-Hz, 100-μs, active TENS 2 intervention consisted in a varying high-frequency (80-100 Hz), 350 μs, and in a placebo group, participants were connected to the TENS unit without electrical stimulation. TENS was applied with two self-adhesive electrodes placed parallel to the spinal cord (T10-L1 and S2-S4 levels). The primary outcome was pain intensity (0-10 cm) measured on a visual analogue scale (VAS) at several stages (at baseline and at 10 and 30 min later). Secondary outcomes included women's satisfaction (via the Care in Obstetrics: Measure for Testing Satisfaction scale). RESULTS Sixty-three women participated. Regarding baseline characteristics, no differences were found among the three groups. The active TENS 2 group obtained an improvement with clinically significant VAS results (- 2.9, 95% confidence interval - 4.1 to - 1.6, p < 0.001). Regarding satisfaction, the results also revealed better results in the active TENS than in the placebo group. CONCLUSIONS TENS with high frequencies modified in time as well as high pulse width are effective for relieving labour pain, and they are well considered by pregnant participants. TRIAL REGISTRATION ClinicalTrials.gov, NCT03137251 . Registered on 2 May 2017.
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Affiliation(s)
- Aníbal Báez-Suárez
- Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n, 35016 Las Palmas de Gran Canaria, Las Palmas, Spain.
| | - Estela Martín-Castillo
- Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n, 35016 Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Josué García-Andújar
- Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n, 35016 Las Palmas de Gran Canaria, Las Palmas, Spain
| | - José Ángel García-Hernández
- Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n, 35016 Las Palmas de Gran Canaria, Las Palmas, Spain
| | - María P Quintana-Montesdeoca
- Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n, 35016 Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Juan Francisco Loro-Ferrer
- Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n, 35016 Las Palmas de Gran Canaria, Las Palmas, Spain
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