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Yadollahi P, Bozorgian L, Janghorban R. The relationship between Iranian women's perception of their birth team's compliance with medical ethics and their perception of labor pain. BMC Pregnancy Childbirth 2024; 24:70. [PMID: 38245719 PMCID: PMC10799432 DOI: 10.1186/s12884-024-06269-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND A safe and satisfactory childbirth experience with the least amount of pain constitutes one of the main domains of reproductive healthcare. The most important aspect of labor pain management is the moral and professional commitment of the health professionals and caregivers involved in creating a pleasant delivery. The present study examines the relationship between Iranian women's perceptions of their birth team's compliance with medical ethics and their perception of labor pain. METHODS This cross-sectional study was conducted on 200 women opting for natural childbirth. The samples were selected by convenience sampling. Three questionnaires, including a demographic information questionnaire, the perception of labor pain questionnaire, and the medical ethics attitude in vaginal delivery questionnaire, were used to collect data. The data were entered into SPSS 22 and analyzed using correlation coefficient and multiple regression tests. The significance level for data analysis was set as less than 0.05. RESULTS The results of the regression analysis showed that among the four principles of medical ethics, only the second and third principles (beneficence and non-maleficence) predicted the perception of labor pain (B = -0.267, P < 0.037). Among the different domains of these principles, the areas of giving the necessary information to the mother (B = -0.199, P = 0.001), respecting the mother's privacy (B = -0.194, P = 0.001), interaction with the mother (B = -0.287, P = 0.001) and assurance of fetal health (B = -0.492, P = 0.001) were predictors of labor pain perception score. CONCLUSIONS Compliance of the birth team with respecting the mother's privacy, having friendly interactions with the mother and giving fetal health assurance to the mother can be a predictor of the mother's decreased perception of labor pain.
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Affiliation(s)
- Parvin Yadollahi
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Bozorgian
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roksana Janghorban
- Department of Midwifery, School of Nursing and Midwifery, Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Mohammadi H, Rasti J, Ebrahimi E. Virtual Reality, Fear of Pain and Labor Pain Intensity: A Randomized Controlled Trial. Anesth Pain Med 2023; 13:e130387. [PMID: 37489168 PMCID: PMC10363358 DOI: 10.5812/aapm-130387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 07/26/2023] Open
Abstract
Background Labor and delivery are physiological conditions that occur due to the contraction of the smooth muscles of the uterus. Labor pain is one of the most severe pains that anyone can experience, and its control is one of the most important goals of health care. Methods This study was performed on 130 healthy pregnant women who had gestational ages of 37 to 40 weeks and were randomly assigned to the intervention and control groups using the closed envelope technique. Then a virtual reality (VR) headset containing a game was provided to the study subjects in the intervention group. The Harman Fear of childbirth questionnaire and visual analog scale (VAS) were completed at different times across labor according to the study protocol. The minimum time for using the headset was 20 minutes until the end of the first stage of labor. Data were analyzed using the chi-square test, independent t-test, and repeated measures test via SPSS software version 20. Results The results showed a significant difference in pain score between the study groups. Despite expecting increasing pain intensity with labor progression, participants in the VR group reported less pain intensity and fear of labor pain compared to control subjects (F = 8.18, P < 0.05, between four and ten cervical dilatations). Conclusions Virtual reality interventions can be regarded as a new non-pharmaceutical strategy to control labor pain and fear of normal vaginal delivery in pregnant women.
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Affiliation(s)
- Halimeh Mohammadi
- Msc in Midwifery, Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Rasti
- Assistant Professor, Biomedical Engineering Department, Faculty of Engineering, University of Isfahan, Isfahan, Iran
| | - Elham Ebrahimi
- Assistant Professor of Reproductive Health, Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Saedi N, Shokouhi N, Feizabad E, Moghimi Z, Mohseni M. Transcutaneous electrical nerve stimulation with the injection of pethidine and promethazine in the labor pain reduction: A randomized controlled trial. Caspian J Intern Med 2023; 14:628-632. [PMID: 38024177 PMCID: PMC10646370 DOI: 10.22088/cjim.14.4.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/20/2022] [Accepted: 07/31/2022] [Indexed: 12/01/2023]
Abstract
Background The use of transcutaneous electrical nerve stimulation (TENS) to relieve labor pain remains controversial and existing evidence is neither strong nor consistent. This research was designed to compare TENS' effect with the injection of pethidine and promethazine in labor pain reduction. Methods In this trial, for 45 pregnant women in the active phase of labor, TENS electrodes were placed (two on both arms, and two over the participants' low back) continuously for 120 minutes; and for another group 45 pregnant women, 100 milligrams of pethidine and 250 micrograms of promethazine were injected intramuscularly which could be repeated once at least one hour later. Labor pain and duration, need for labor induction/augmentation/other pain control methods/ instrumental delivery, delivery type, and maternal and newborn complications were measured in both groups. Results The baseline mean visual analog scale (VAS) score, in the TENS group was 8.51±0.62 and in the pethidine and promethazine groups was 8.37±0.61 (P=0.31). While in a 120min post-intervention, it was 6.29±1.50 and 5.73±1.46 in the TENS group and the pethidine and promethazine group, respectively with no statistically significant difference (P=0.07). The labor duration in the TENS group was 6.61±1.71 hours and in the pethidine and promethazine group was 6.17±2.07 hours, with no statistically significant difference (P=0.33). In addition, no complication was recorded neither in the mothers nor newborns. Conclusion This study showed that applying TENS in the active labor phase can reduce at least two scores in patient labor pain with no significant complications.
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Affiliation(s)
- Nafiseh Saedi
- Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Shokouhi
- Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Feizabad
- Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Moghimi
- Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Mohseni
- Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Rahmati J, Shahriari M, Shahriari A, Nataj M, Shabani Z, Moodi V. Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia. Anesth Pain Med 2021; 11:e113350. [PMID: 34336624 PMCID: PMC8314089 DOI: 10.5812/aapm.113350] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/17/2021] [Accepted: 04/04/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives This study aimed to compare the analgesic effect of single-dose spinal versus epidural analgesia for labor pain to verify if applying a single dose spinal analgesia is an efficient technique for labor pain management as an alternative for epidural analgesia. Methods A total of 128 women in the active phase of labor were randomly allocated into two groups of spinal analgesia (n = 64) and epidural analgesia (n = 64). The latter received a bolus dose of 16 mL of 0.125% bupivacaine and 50 μg fentanyl and repeated 5 - 10 mL of bolus dose. The former received 2.5 mg hyperbaric bupivacaine plus 50μg fentanyl. Pain intensity was measured using the visual analog scale (VAS). The duration of analgesia, mode of delivery, the duration of labor, side effects, and maternal satisfaction were also compared. Results There were no significant differences in the rate of cesarean section, duration of labor, postpartum hemorrhage, and the frequency of the fetal heart deceleration until 30 min after analgesia between the two groups. Measured pain after 30 (P = 0.0001) and 90 min (P = 0.01) was significantly lower in the spinal group than the epidural group. However, there was no significant difference between the spinal and epidural groups concerning the VAS scores at 150, 210, and 270 minutes. Maternal satisfaction was higher in the spinal group (P = 0.002). The mean duration of analgesia was longer in the spinal group than the epidural group (P = 0.0001). Conclusions According to the findings, single-dose spinal analgesia, compared to epidural analgesia, is a safe, fast, and efficient technique for labor analgesia, which can be easily performed. In addition, it provides a high satisfaction level in the parturient.
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Affiliation(s)
- Javad Rahmati
- Aesthetic Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Shahriari
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran.
| | - Masoomeh Nataj
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Shabani
- Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vihan Moodi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Mirteimouri M, Pourali L, Soltani M, Salehi M, Vatanchi A, Abolkheir AZ. Comparison of Pain Score and Complications Following Acetaminophen and Pethidine Injection During Vaginal Delivery: A Double-blind
Clinical Trial. Oman Med J 2021; 36:e250. [PMID: 33936778 PMCID: PMC8072821 DOI: 10.5001/omj.2021.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 08/30/2020] [Indexed: 11/30/2022] Open
Abstract
Objectives Recently, intravenous acetaminophen has been introduced as an intervention with analgesic potential similar to that of opioid analgesics in labor pain management. This study aimed to compare the pain score and maternal and neonatal complications following acetaminophen and pethidine injections during vaginal delivery. Methods This randomized, double-blind clinical trial was conducted on pregnant women during the first stage of delivery referred to Ghaem and Omolbanin Hospitals in Mashhad, Iran, from March to December 2017. The subjects were assigned randomly to one of two groups: acetaminophen and pethidine. The pain intensity was measured before and 15, 60, 120, 180, and 240 minutes after injection. Results The pain score and pain score changes showed no significant difference between the two groups at different times. The incidence of maternal complications during delivery and the first hour after delivery was not statistically significant between the two groups, but 15 minutes after injection, vomiting (p = 0.001), nausea (p = 0.001), and dizziness (p = 0.001) were significantly higher in the pethidine group. The mean one and five minutes Apgar scores were significantly higher in the acetaminophen group. Conclusions Intravenous acetaminophen led to fewer maternal complications than pethidine, especially during the first 15 minutes after injection and fewer neonatal complications, especially in the Apgar score.
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Affiliation(s)
- Masoumeh Mirteimouri
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Pourali
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mozhgan Soltani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Salehi
- Department of Socio-medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atiyeh Vatanchi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Manouchehrian N, Rabiei S, Moradi A, Lakpur Z. Comparison of Intrathecal Injection of Fentanyl and Sufentanil on the Onset, Duration, and Quality of Analgesia in Labor: A Randomized, Double-Blind Clinical Trial. Anesth Pain Med 2020; 10:e99843. [PMID: 32944556 PMCID: PMC7472646 DOI: 10.5812/aapm.99843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/22/2020] [Accepted: 05/08/2020] [Indexed: 01/20/2023] Open
Abstract
Background Labor pain is a severe pain, and intrathecal opioid injection is one of the analgesia methods to reduce it. Objectives We assessed the effects of intrathecal Fentanyl and Sufentanil on the onset, duration, and quality of analgesia for labor analgesia. Methods In this double-blind, randomized clinical trial, 54 healthy nulliparous women 18 - 45 years in the active phase of labor who were requesting labor analgesia were enrolled in two groups fentanyl (F) and sufentanil (S). Patients received 75 µg fentanyl or 7.5 µg sufentanil intrathecally in the fentanyl group (n = 27) and the sufentanil group (n = 27), respectively. Pain relief, onset, duration of analgesia, hemodynamic parameters, patients' satisfaction, and neonatal Apgar score were assessed in this study. Data were analyzed by using SPSS16. Results There were no significant differences between the groups in terms of demographic and hemodynamic parameters. The onset time of analgesia was 5.6 ± 4.3 and 3.6 ± 2.1 minutes, in the sufentanil and fentanyl groups, respectively (P = 0.037). The duration of analgesia was higher in patients who received sufentanil than those who received fentanyl (113 ± 45 vs. 103 ± 22 minutes (P = 0.629)). The pain score in the Fentanyl group was significantly lower at 5, 10, and 15 minutes after spinal analgesia (P < 0.05). The sedation score at 1 and 5 minutes was significantly higher in the fentanyl group than the sufentanil group (P < 0.05). The frequency and severity of pruritus and satisfaction rate in the fentanyl group were significantly higher than the sufentanil group. Conclusions Intrathecal fentanyl and sufentanil have a similar analgesic effect on labor. Fentanyl is associated with a faster onset of analgesia and more satisfaction, while sufentanil has longer analgesia.
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Affiliation(s)
- Nahid Manouchehrian
- Department of Anesthesiology, Hamadan University of Medical Sciences, Hamadan, Iran
- Corresponding Author: Department of Anesthesiology, Fatemi Medical Center, Hamadan University of Medical Sciences, Pasdaran St, Hamadan, Iran.
| | - Soghra Rabiei
- Department of Obstetrics and Gynecology, Fatemi Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Moradi
- Medical Sciences Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Lakpur
- Medical Sciences Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Kaur J, Sheoran P, Kaur S, Sarin J. Effectiveness of Warm Compression on Lumbo-Sacral Region in Terms of Labour Pain Intensity and Labour Outcomes among Nulliparous: an Interventional Study. J Caring Sci 2020; 9:9-12. [PMID: 32296653 PMCID: PMC7146727 DOI: 10.34172/jcs.2020.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/25/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction: Childbirth is a distinctive and joyous moment in every mother’s life. Giving birth is one of the powerful and vital event. This study aimed to assess and evaluate the effectiveness of warm compression (moist heat) on lumbo-sacral region in terms of labor pain intensity and labor outcomes Methods: An experimental research design was carried out on 88 nulliparous mothers with normal singleton term pregnancy (44 participants in each group) who were admitted in the labor room. Mothers who had high-risk pregnancy were excluded. Warm compression was given to nulliparous mothers of the experimental group with hydrochollator pack at 70◦C temperature for 20 minutes for 3 times with one-hour interval on lumbo sacral region starting from 4-5 cm of cervical dilatation. Labor pain intensity score, fetal heart rate, frequency and duration of uterine contractions were assessed before and immediately of warm compression and again after 30 minutes only labor pain was assessed. Results: Study results revealed that immediately after first, second and third time of warm compression labor pain intensity score in experimental group was lower than control group respectively ( t= 3.20; P< 0.001; t =4.45; P< 0.001; t= 6.18; P< 0.001). But no significant difference found in fetal heart rate and labor outcomes in terms of duration of labor, type of delivery, baby born alive/ not and cried immediately after birth. Conclusion: Warm compression was useful method to decrease the labour pain among nulliparous mothers in the first stage of labour and mothers reported satisfaction with intervention.
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Affiliation(s)
- Jasvir Kaur
- Department Obstetrics and Gynaecological Nursing, Maharishi Markandeshwar College of Nursing, Maharishi Markandeshwar Deemed to be University, Mullana, India
| | - Poonam Sheoran
- Department Obstetrics and Gynaecological Nursing, Maharishi Markandeshwar College of Nursing, Maharishi Markandeshwar Deemed to be University, Mullana, India
| | - Simarjeet Kaur
- Department Obstetrics and Gynaecological Nursing, Maharishi Markandeshwar College of Nursing, Maharishi Markandeshwar Deemed to be University, Mullana, India
| | - Jyoti Sarin
- Nursing Faculty, Maharishi Markandeshwar Deemed to be University, Mullana, India
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Abedi P, Rastegar H, Valiani M, Saadati N. The Effect of Auriculotherapy on Labor Pain, Length of Active Phase and Episiotomy Rate Among Reproductive Aged Women. J Family Reprod Health 2017; 11:185-190. [PMID: 30288164 PMCID: PMC6168759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objective: This study aimed to evaluate the effect of auriculotherapy on labor pain, the length of the active phase, and episiotomy rate among reproductive aged Iranian women. Materials and methods: In this study, 80 women were assigned to two groups: auriculotherapy (n = 40) and control group (n = 40). Auriculotherapy was performed in the earlobe in the Zero, Shen Men, Uterus, Pelvic, Abdomen, Spleen, External genitalia, and Master cerebral regions in the cervix dilation of 4, 6, and 8 cm between uterine contractions. The control group received routine hospital care. The labor pain, duration of the active phase, and rate of episiotomy were assessed in two groups. The independent t- test and chi-square were used for statistical purposes. Results: The mean of labor pain during the active phase was 7.56 ± 0.83 in the auriculotherapy group and 8.43 ± 0.69 in the control group (p < 0.001). The length of active phase was significantly lower in the auriculotherapy than that in the control group (176.2 ± 1 min vs. 342.8±87.2 min, p < 0.001). The rate of normal vaginal delivery (without an episiotomy or perineal tears) was significantly higher in the auriculotherapy group than that in the control group (50% vs. 2.5%, p < 0.001). Conclusion: Auriculotherapy is safe, cost effective and devoid of side effects to reduce the labour pain, length of the active phase and the rate of episiotomy in nulliparous women. This method can be considered as a complementary medicine in labour.
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Affiliation(s)
- Parvin Abedi
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hoda Rastegar
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahboobeh Valiani
- Department of Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Najimeh Saadati
- Department of Obstetrics & Gynecology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Fellowship Perinatology Ward, Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Vaziri F, Arzhe A, Asadi N, Pourahmad S, Moshfeghy Z. Spontaneous Pushing in Lateral Position versus Valsalva Maneuver During Second Stage of Labor on Maternal and Fetal Outcomes: A Randomized Clinical Trial. Iran Red Crescent Med J 2016; 18:e29279. [PMID: 28180019 PMCID: PMC5286842 DOI: 10.5812/ircmj.29279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 06/06/2015] [Accepted: 06/30/2015] [Indexed: 11/29/2022]
Abstract
Background There are concerns about the harmful effects of the Valsalva maneuver during the second stage of labor. Objectives Comparing the effects of spontaneous pushing in the lateral position with the Valsalva maneuver during the second stage of labor on maternal and fetal outcomes. Methods Inclusion criteria in this randomized clinical trial conducted in Iran were as follows: nulliparous mothers, live fetus with vertex presentation, gestational age of 37 - 40 weeks, spontaneous labor, and no complications. The intervention group pushed spontaneously while they were in the lateral position, whereas the control group pushed using Valsalva method while in the supine position at the onset of the second stage of labor. Maternal outcomes such as pain and fatigue severity and fetal outcomes such as pH and pO2 of the umbilical cord blood were measured. Results Data pertaining to 69 patients, divided into the intervention group (35 subjects) and control group (34 subjects), were analyzed statistically. The mean pain (7.80 ± 1.21 versus 9.05 ± 1.11) and fatigue scores (46.59 ± 21 versus 123.36 ± 43.20) of the two groups showed a statistically significant difference (P < 0.001). Moreover, the mean duration of the second stage in the intervention group was significantly higher than that in the control group (76.32 ± 8.26 minutes versus 64.56 ± 15.24 minutes, P = 0.001). The umbilical cord blood pO2 levels of both groups showed a statistically significant difference (28.29 ± 11.76 versus 18.83 ± 9.86, P < 0.001), whereas their pH levels were not significantly different (P = 0.10). Conclusions Spontaneous pushing in the lateral position reduced fatigue and pain severity of the mothers. Also, it did not worsen fetal outcomes. Thus, it can be used as an alternative method for the Valsalva maneuver.
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Affiliation(s)
- Farideh Vaziri
- Department of Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding Author: Farideh Vaziri, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-71136474254, Fax: +98-71136474252, E-mail:
| | - Amene Arzhe
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Nasrin Asadi
- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Saeedeh Pourahmad
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Zeinab Moshfeghy
- Department of Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran
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Mobaraki N, Yousefian M, Seifi S, Sakaki M. A Randomized Controlled Trial Comparing Use of Enthonox With Pethidine for Pain Relief in Primigravid Women During the Active Phase of Labor. Anesth Pain Med 2016; 6:e37420. [PMID: 27843776 PMCID: PMC5100341 DOI: 10.5812/aapm.37420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/26/2016] [Accepted: 07/05/2016] [Indexed: 11/16/2022] Open
Abstract
Background The use of pain-relieving drugs during labor is now part of standard care in many countries throughout the world. Each method of pain relief has its own risks and benefits, variations in effectiveness, and availability and acceptability. Objectives This study aimed to assess the efficacy and safety of intramuscular pethidine as an analgesic during labor by comparing it to inhaled 50% nitrous oxide (Entonox). Methods In this clinical trial study, 100 women who expected to have a natural childbirth were observed. The inclusion criteria for this study were the commencement of spontaneous labor pain along with appropriate maternal and fetal indications for vaginal delivery. By using random numbers, each subject was randomly allocated to one of two groups, with one group using Entonox and the other receiving an intramuscular injection of 0.5 mg/kg of pethidine for pain relief. The intensity of labor pain experienced by the subjects and the outcomes of the deliveries were collected with questionnaires. Results The average pain scores in the Entonox and pethidine groups were 3.94 ± 1.4 and 5.6 ± 1.1, respectively, 30 minutes after intervention (P = 0.001), but there was not a significant difference in the severity of the pain (5.06 ± 1.4 and 4.7 ± 1.1 for the Entonox and pethidine groups, respectively) between the subjects in each group 60 minutes after the intervention (P = 0.592). No significant differences were seen in the duration and interval of uterine contractions, maternal complications, Apgar scores, and the duration of the first and second stage of labor between the two studied groups (P > 0.05). An analysis of the pooled risk differences showed that none of the side effects investigated were significantly different between the two groups except for mouth dryness, which was significantly higher in nitrous oxide users (P = 0.044). Conclusions Inhaled nitrous oxide seems to give better pain relief in the short term compared to a single dose of pethidine. Entonox, which is more convenient to administer than an intramuscular injection of pethidine, is also regarded as safe both for mothers and neonates.
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Affiliation(s)
- Noshin Mobaraki
- Department of Obstetrics and Gynecology, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mahzad Yousefian
- Department of Anesthesiology, Ardabil University of Medical Sciences, Ardabil, Iran
- Corresponding author: Mahzad Yousefian, Department of Anesthesiology, Ardabil University of Medical Sciences, Ardabil, Iran, E-mail:
| | - Solmaz Seifi
- Department of Obstetrics and Gynecology, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehran Sakaki
- Department of Pathology, Ardabil University of Medical Sciences, Ardabil, Iran
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Jamshidi Manesh M, Kalati M, Hosseini F. Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial. Iran Red Crescent Med J 2015; 17:e18373. [PMID: 26082849 PMCID: PMC4464378 DOI: 10.5812/ircmj.17(5)2015.18373] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 07/08/2014] [Accepted: 09/02/2014] [Indexed: 12/28/2022]
Abstract
Background: One of the strategies for a good outcome and pain free childbearing is to design the delivery room. Objectives: The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women. Patients and Methods: This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation. Results: The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants’ intervention vs. 66% of control participants had perinea laceration (P = 0.041). Conclusions: According to the findings of the present study, distracting senses in snoezelen room decreases mother’s pain intensity, the length of labor, and incidence of episiotomy.
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Affiliation(s)
| | - Mahnaz Kalati
- Labor and Childbirth Ward, Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Mahnaz Kalati, Labor and Childbirth Ward, Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, IR Iran. E-mail:
| | - Fatemeh Hosseini
- Department of Biostatistics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, IR Iran
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14
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Yesilcicek Calik K, Komurcu N. Effects of SP6 Acupuncture Point Stimulation on Labor Pain and Duration of Labor. Iran Red Crescent Med J 2014; 16:e16461. [PMID: 25558386 PMCID: PMC4270652 DOI: 10.5812/ircmj.16461] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 04/26/2014] [Accepted: 05/19/2014] [Indexed: 11/21/2022]
Abstract
Background: Acupressure has been used frequently to improve labor, manage labor pain, and shorten delivery time. However, there has been little research-based evidence to support the positive effects of acupressure in the obstetric area and obstetric nursing. Objectives: The aim of this study was to evaluate the effects of SP6 acupressure on labor pain and delivery time in primigravida women in labor. Patients and Methods: The study was conducted at the Trabzon Maternity Hospital in Turkey. Its design was a randomized controlled clinical trial study using a single-blinded method. One hundred (100) primigravida women in labor were randomly assigned to either the SP6 acupressure (n = 50) or control group (n = 50). Acupressure was practiced 35 times in total on the SP6 point of both legs in the SP6 acupressure group; 15 times (during contraction) when cervical dilation was 2-3 cm, 10 times when cervical dilation was 5-6 cm and 10 times at 9-10 cm dilation, while the women in the control group received standard care. Labor pain was measured five times using a structured questionnaire of a subjective labor pain scale (visual analogue scale-VAS) when dilation was 2-3 cm (VAS 2), 5-6 cm (VAS 3) and 8-9 cm (VAS 4) before and after acupressure was applied to the SP6 point (VAS 1), and finally at the early postpartum period (VAS 5). The duration of labor in both groups was measured with a partograph and the length of delivery time was calculated in two stages: from 3 cm cervical dilation to full cervical dilation, and from full cervical dilation to delivery. Results: There were significant differences between the groups in subjective labor pain scores (except VAS 4) (P < 0.001). The duration of the Phase one (3 cm dilatation to full dilatation) and Phase two (full dilatation to birth) in the acupressure group was shorter than the control group (Phase one, 225 min and 320 min, respectively; Phase two, 15 min and 20 min, respectively; both P < 0.001). Conclusions: It was determined that SP6 acupressure was effective in decreasing pain and duration of labor.
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Affiliation(s)
- Kiymet Yesilcicek Calik
- epartment of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
- Corresponding Author: Kiymet Yesilcicek Calik, Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey. Tel: +90-4622300476, Fax: +90-4622300475, E-mail:
| | - Nuran Komurcu
- Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
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15
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Pasha H, Basirat Z, Hajahmadi M, Bakhtiari A, Faramarzi M, Salmalian H. Maternal expectations and experiences of labor analgesia with nitrous oxide. Iran Red Crescent Med J 2012; 14:792-7. [PMID: 23483128 PMCID: PMC3587869 DOI: 10.5812/ircmj.3470] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 05/12/2012] [Accepted: 06/30/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although there are various methods for painless delivery such as using entonox gas, most of the people are unfamiliar or concerned about it yet. OBJECTIVES The purpose of this study was to assess maternal expectations and experience of labor analgesia with nitrous oxide. PATIENTS AND METHODS In a clinical trial study, 98 pregnant women in active phase of delivery were studied randomly in two groups (intervention group = 49, control group = 49) after obtaining written consent. Efficacy, experience satisfaction, and also expectation of pregnant women about entonox gas in two groups were compared, likewise in intervention group before and after using entonox gas. RESULTS Most of the pregnant women receiving entonox gas had less labor pain (91.8%), and were satisfied with it (98%). The severity of pain in the most of entonox user was moderate level (46.94%), while for the control group it was severe (55.10%) which was significant, 40.82% of the mother in entonox group had a severe pain and 10.20% had a very severe pain, whereas in the control group (55.10%) of the mother had a severe pain and 26.53% of the had very severe pain (P = 0.004). efficacy of labor pain was in moderate level in most cases. 49% of pregnant women receiving gas described their experience as a good and excellent. 80.9% indicated that they will request the mentioned painless method in the future. The amount of suffering from gas side effects was mild in most patients of intervention group (63%). Expectations of the majority of pregnant women in intervention group (before receiving gas) and control group for painless delivery were weak (65.3%, 40.9%). The percentage of positive expectations had increased after receiving entonox gas (P = 0.01). There was a difference between the expectations of intervention group receiving entonox gas and control group (P = 0.001). Positive expectations were more in intervention group than the control group. Most differences of expectations in intervention group before and after receiving the gas were about higher efficacy (P = 0.001), more satisfaction (P = 0.001), fewer complications (P = 0.001), information about gas as painless delivery method (P = 0.02), and also previous experience of intolerable labor pain (P = 0.04). CONCLUSIONS This study has shown that using entonox gas caused less labor pain, favorable expectations and experiences and also more maternal satisfaction.
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Affiliation(s)
- Hajar Pasha
- Fatemeh Zahra Fertility and Infertility Health Research Center, Babol University of Medical Sciences, Babol, IR Iran
| | - Zahra Basirat
- Fatemeh Zahra Fertility and Infertility Health Research Center, Babol University of Medical Sciences, Babol, IR Iran
| | - Mahmood Hajahmadi
- Community Medicine, Babol University of Medical Sciences, Babol, IR Iran
| | - Afsaneh Bakhtiari
- Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran
| | - Mahbobeh Faramarzi
- Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran
| | - Hajar Salmalian
- Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran
- Corresponding author: Hajar Salmalian, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran. Tel.: +98-1112199592-3, Fax: +98-1112199936, E-mail:
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