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Pushing method in the expulsive phase of labor. A randomized trial
C Parnell1, J Langhoff-Roos, R Iversen
1Department of Obstetrics and Gynecology, Rigshospitalet, Copenhagen, Denmark.
Acta Obstetricia Et Gynecologica Scandinavica
|January 1, 1993
Summary
Spontaneous pushing in labor did not significantly change outcomes compared to forced pushing. However, the open glottis technique shortened labor and resulted in smaller infants.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatal Research
Background:
- The second stage of labor involves pushing, which can be spontaneous or forced.
- Previous research suggested spontaneous pushing might lead to better outcomes.
Purpose of the Study:
- To compare spontaneous versus forced pushing in the second stage of labor.
- To evaluate the impact of pushing techniques on labor duration and maternal-child outcomes.
Main Methods:
- A randomized trial involving 350 primiparous women.
- Comparison of spontaneous urge pushing versus directed (forced) pushing.
- Analysis of labor duration, fetal umbilical arterial pH, and birth canal trauma.
Main Results:
- No significant differences were found between spontaneous and forced pushing groups in labor duration, fetal pH, or birth canal damage.
- Women using the open glottis technique experienced a shorter second stage of labor.
- Infants born to mothers using the open glottis technique had lower birth weights.
Conclusions:
- Recommending spontaneous pushing did not yield significant improvements in labor duration, fetal pH, or birth canal integrity.
- The open glottis pushing technique was associated with a shorter expulsive phase and smaller infant size.