Use of Subdermal Sterile Water Injection toRelievePain in Labour and its Effect in Mode of Delivery

To assess the use of subdermal sterile water injections (SWIs) as a cost-effective and reliable analgesia option for labouring women in setups with high patient flow, limited staff availability, and favourable delivery outcomes.

Randomised clinical trial. Place and Duration of the Study: Department of Maternal and Child Health, Pakistan Institute of Medical Sciences Hospital, Islamabad, Pakistan, from August 2024 to January 2025.

A total of 212 labouring women in the active stage of labour were randomly assigned using the lottery method to either the Trial group, which received subdermal SWIs, or the Control group, which received the standard labour ward protocol. Pain levels were assessed using the Numerical Pain Scale (NPS), with a pain-score of <7 considered indicative of effective pain control. The primary outcome was the pain control before and after the intervention, while the secondary outcome was the mode of delivery. The Mann-Whitney U test and the chi-square test were used to compare variables between groups. The Wilcoxon signed-rank test was used to compare pain scores before and after the intervention within the trial group.

The study indicated that 94% of women in the Trial group reported effective pain relief (NPS 4-6) at 10, 30, and 60 minutes after the use of SWIs compared to the Control group, which was considered clinically significant. Additionally, 92% of women in each group had a normal vaginal delivery (p >0.05), making no difference in delivery outcomes in both groups.

This study shows that the use of subdermal SWIs is an effective method for labour pain relief and represents a cost-effective analgesic option for labour pain management in low-resource settings.

Sterile water, Subdermal, Labour pain, Analgesia, Epidural, Vaginal delivery.