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Visual biofeedback for shortening second stage of labor: randomized controlled trial
E Preuss1,2, A De Porto1,2, I Zisman1,2
1Department of Obstetrics and Gynecology, Samson Assuta Ashdod University Hospital, Ashdod, Israel.
Summary
Visual biofeedback during labor did not shorten the second stage of labor or reduce instrumental delivery rates. However, it did improve fetal head descent during maternal pushing, suggesting potential benefits for labor progression.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Medical Ultrasound Applications
Background:
- The second stage of labor can be prolonged, potentially increasing the need for instrumental delivery.
- Visual biofeedback using transperineal ultrasound has been explored as an intervention to improve maternal pushing effectiveness.
Purpose of the Study:
- To evaluate if visual biofeedback during labor can shorten the second stage.
- To determine if visual biofeedback reduces the requirement for instrumental delivery.
- To assess the impact of visual biofeedback on fetal head progression during pushing.
Main Methods:
- A single-center randomized controlled trial involving nulliparous women under epidural anesthesia.
- Participants were randomized into a biofeedback group (n=50) or a control group (n=50).
- The biofeedback group observed transperineal ultrasound images during coached pushing, while the control group did not.
Main Results:
- No significant difference in the duration of the second stage of labor between the biofeedback and control groups (2.28 vs 2.08 hours).
- Significantly greater fetal head descent (angle of progression) was observed in the biofeedback group during pushing.
- Similar rates of intact perineum were reported in both groups (12% vs 8%).
Conclusions:
- Visual biofeedback may enhance fetal head descent during maternal pushing in the second stage of labor.
- The short duration of the biofeedback intervention might explain the lack of effect on overall second-stage duration.
- Further research is recommended to investigate continuous visual biofeedback throughout the second stage of labor.
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