British journal of obstetrics and gynaecology · 1998
Immediate and delayed pushing in the second stage of labour for nulliparous women with epidural analgesia: a randomised controlled trial.
Клиническое исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Vause S, Congdon H M, Thornton J G
Аннотация
OBJECTIVE: To test the hypothesis that a policy of delaying active pushing in nulliparous women with epidural analgesia in labour reduces operative vaginal deliveries.
DESIGN: A randomised controlled trial.
SETTING: The delivery suite at Leeds General Infirmary.
SAMPLE: One hundred and thirty-five nulliparous women with an effective epidural in labour.
METHODS: The women were randomised to early pushing (commencement of pushing within one hour of the diagnosis of full dilatation) or delayed pushing (delaying pushing for a maximum of three hours from the time of diagnosis of full dilatation, unless the vertex was visible at the introitus sooner.
MAIN OUTCOME MEASURE: Rate of instrumental vaginal delivery.
RESULTS: There was a nonsignificantly increased rate of instrumental vaginal delivery with early pushing (odds ratio 1.31, 95% CI 0.62-2.78). No adverse effects were noted.
CONCLUSION: Although delayed pushing was associated with fewer instrumental vaginal deliveries, the size of the effect may have occurred by chance and the evidence does not, at present, justify a general recommendation towards either early or delayed pushing.
DESIGN: A randomised controlled trial.
SETTING: The delivery suite at Leeds General Infirmary.
SAMPLE: One hundred and thirty-five nulliparous women with an effective epidural in labour.
METHODS: The women were randomised to early pushing (commencement of pushing within one hour of the diagnosis of full dilatation) or delayed pushing (delaying pushing for a maximum of three hours from the time of diagnosis of full dilatation, unless the vertex was visible at the introitus sooner.
MAIN OUTCOME MEASURE: Rate of instrumental vaginal delivery.
RESULTS: There was a nonsignificantly increased rate of instrumental vaginal delivery with early pushing (odds ratio 1.31, 95% CI 0.62-2.78). No adverse effects were noted.
CONCLUSION: Although delayed pushing was associated with fewer instrumental vaginal deliveries, the size of the effect may have occurred by chance and the evidence does not, at present, justify a general recommendation towards either early or delayed pushing.