Effect of upright and ambulant positions versus lying down during the active first stage of labor on birth outcomes among nulliparous women:randomized controlled clinical trial

Objective:To examine the effect of upright and ambulant positions versus lying down during the active first stage of labor on birth outcomes for nulliparous women.Methods:This is a randomized controlled clinical trial conducted at the delivery department of Damanhour Educational Institute,El Behira Governorate,Egypt.The study sample involved 150 parturient women equally divided into intervention and control groups using randomization block technique.The researchers used four tools for data collection:Demographic data interview schedule,World Health Organization Partograph,Apgar’s score,to evaluate neonatal outcomes,and visual analogue pain intensity scale.For the study group,the parturient women were encouraged to assume one of the upright positions or ambulating around the bed so as to maintain the pelvis in vertical plane as far as possible for 20-25 min for every 1 h.The control group received routine hospital care,which includes lying down in bed.IBM SPSS 23.0 was used to analyze the data.Results:Significant differences(P<0.05)were observed between the study and control groups in relation to cervical dilation,fetal head descent,uterine contractions interval,and frequency.The duration of the first stage of labor significantly reduced(P=0.018)in the intervention group compared with control group.No significant differences(P>0.05)were observed between both groups in term of emergency cesarean birth rates,oxytocin use,and neonatal outcomes.Conclusions:This study proves that upright and ambulant positions significantly enhance uterine contractility,cervical dilatation,and fetal head descent and reduce the first stage duration.

Effect of Acupoint Sanyinjiao(SP6) Moxibustion on the First Stage of Labor and Uterine Contractive Pain in Primiparae

Objective：To observe the effect of acupoint Sanyinjiao（SP6） moxibustion（S-Mox） on the duration of the first labor stage and uterine contractive pain in primiparae.Methods：Sixty primipara women in labor were equally assigned according to their choice to three groups：women in the S-Mox group received bilateral S-Mox for 30 min,women in the non-acupoint group received moxibustion（Mox） applied on non-acupoints for 30 min,and those in the control group did not receive Mox intervention.The duration of the first labor stage was recorded and the degree of labor pain was estimated by a visual analogue scale（VAS） before and after Mox. Results：The duration of the first stage active phase in the S-Mox group was significantly shorter than that in the other two groups（P0.05,P0.01）;the VAS score after Mox was lower in the S-Mox group,showing a statistical difference in comparison with the control group（P0.05）.Conclusions：Applying S-Mox could markedly shorten the active phase of the first stage of labor and lower the VAS score of uterine contractive pain,which means alleviating the pain caused by vaginal delivery.Its mechanism is worthy of further study.