2.50
Hdl Handle:
http://hdl.handle.net/10755/157494
Type:
Presentation
Title:
LABORING DOWN
Abstract:
LABORING DOWN
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Emrick, Terry L., BSN, RN
P.I. Institution Name:Banner Health
Title:Nursing Informatics Coordinator
Contact Address:14502 W. Meeker Blvd, Sun City West, AZ, 85375, USA
Co-Authors:Monica Rhea
PURPOSES/AIMS: The purpose of this study is to determine which method of the management of second stage of labor supports the best practice for women laboring with an epidural. For women in labor with epidural anesthesia, does the use of laboring down improve the fetal and maternal outcomes compared to active pushing at 10 cm dilation?
RATIONALE/CONCEPTUAL BASIS/BACKGROUND: The management of the second stage of labor in women with epidural anesthesia in regards to pushing immediately at complete dilation versus allowing for spontaneous descent without pushing is controversial. There are indications that the fetus is physiologically stressed during the second stage of labor due to the use of sustained valsalva bearing down efforts which are typically used with pushing of women who have received an epidural. The adverse effects to this process are fetal deoxygenation, maternal fatigue, increase in perineal tears which can lead to third and fourth degree lacerations, and an increase in assisted vaginal births, and therefore, a decrease in urogynecological function including a decreased capacity of the bladder and a higher incidence of urodynamic stress incontinence. The conclusion from the literature suggest that further research on the potential advantages of minimizing the duration of pushing in labor is advisable.
METHODS: A randomized controlled study was conducted over a period of several months on Primapara patients admitted in early labor or for a scheduled induction to determine the effects of laboring down versus pushing immediately at 10 cm dilation. A retrospective review of data collected from the study including the review of fetal monitor strips on patients admitted was accomplished.
RESULTS: The researchers recruited 84 women to participate in the program. A total of 66 women were included in the experimental group and 18 in the control group. Data showed an equal distribution of inductions versus spontaneous labor (44 inductions vs. 40 spontaneous labor). 84% of women included in the study were not in active labor on admission. Laboring down time for all subjects was 45.29 minutes.
IMPLICATIONS: Increased awareness of the effects of laboring down on the mother and child among medical and nursing staff members and patients.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleLABORING DOWNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157494-
dc.description.abstract<table><tr><td colspan="2" class="item-title">LABORING DOWN</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Emrick, Terry L., BSN, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Banner Health</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nursing Informatics Coordinator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">14502 W. Meeker Blvd, Sun City West, AZ, 85375, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">terry.emrick@bannerhealth.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Monica Rhea</td></tr><tr><td colspan="2" class="item-abstract">PURPOSES/AIMS: The purpose of this study is to determine which method of the management of second stage of labor supports the best practice for women laboring with an epidural. For women in labor with epidural anesthesia, does the use of laboring down improve the fetal and maternal outcomes compared to active pushing at 10 cm dilation?<br/>RATIONALE/CONCEPTUAL BASIS/BACKGROUND: The management of the second stage of labor in women with epidural anesthesia in regards to pushing immediately at complete dilation versus allowing for spontaneous descent without pushing is controversial. There are indications that the fetus is physiologically stressed during the second stage of labor due to the use of sustained valsalva bearing down efforts which are typically used with pushing of women who have received an epidural. The adverse effects to this process are fetal deoxygenation, maternal fatigue, increase in perineal tears which can lead to third and fourth degree lacerations, and an increase in assisted vaginal births, and therefore, a decrease in urogynecological function including a decreased capacity of the bladder and a higher incidence of urodynamic stress incontinence. The conclusion from the literature suggest that further research on the potential advantages of minimizing the duration of pushing in labor is advisable.<br/>METHODS: A randomized controlled study was conducted over a period of several months on Primapara patients admitted in early labor or for a scheduled induction to determine the effects of laboring down versus pushing immediately at 10 cm dilation. A retrospective review of data collected from the study including the review of fetal monitor strips on patients admitted was accomplished. <br/>RESULTS: The researchers recruited 84 women to participate in the program. A total of 66 women were included in the experimental group and 18 in the control group. Data showed an equal distribution of inductions versus spontaneous labor (44 inductions vs. 40 spontaneous labor). 84% of women included in the study were not in active labor on admission. Laboring down time for all subjects was 45.29 minutes. <br/>IMPLICATIONS: Increased awareness of the effects of laboring down on the mother and child among medical and nursing staff members and patients.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:55:24Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:55:24Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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