[Pain during labour: sterile water injections?]

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Evidence-Based Medicine

Background:

• Dutch midwives began offering sterile water injections for labor pain in 2013.
• This initiative faced criticism from gynecologists and anesthesiologists due to insufficient evidence.

Purpose of the Study:

• To critically appraise existing literature on sterile water injections for labor pain.
• To resolve discrepancies between two recent systematic reviews on the intervention's efficacy.

Main Methods:

• Literature review focusing on two recent systematic reviews.
• Critical appraisal of randomized controlled trials included in the systematic reviews.
• Analysis of primary outcomes, specifically the rate of unplanned cesarean sections.

Main Results:

• Both systematic reviews analyzed largely overlapping randomized trials.
• Discrepancy noted in conclusions regarding unplanned cesarean sections, influenced by minor differences in included trials.
• Estimated effect size was similar, but statistical significance varied between reviews.

Conclusions:

• Conflicting conclusions from systematic reviews necessitate further investigation.
• Ongoing and planned trials are crucial to determine the role of sterile water injections in labor pain management guidelines.