Spontaneous Pushing in Lateral Position versus Valsalva Maneuver During Second Stage of Labor on Maternal and Fetal Outcomes: A Randomized Clinical Trial
نویسندگان
1 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran
2 Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, IR Iran
3 Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, IR Iran
4 Department of Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran
5 Department of Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran
doi
چکیده
There are concerns about the harmful effects of the Valsalva maneuver during the second stage of labor.Objectives: Comparing the effects of spontaneous pushing in the lateral position with the Valsalva maneuver during the secondstage of labor on maternal and fetal outcomes.Methods: Inclusion criteria in this randomized clinical trial conducted in Iran were as follows: nulliparous mothers, live fetus withvertex presentation, gestational age of 37 - 40 weeks, spontaneous labor, and no complications. The intervention group pushedspontaneously while they were in the lateral position, whereas the control group pushed using Valsalva method while in the supineposition at the onset of the second stage of labor. Maternal outcomes such as pain and fatigue severity and fetal outcomes such aspH and pO2 of the umbilical cord blood were measured.Results: Data pertaining to 69 patients, divided into the intervention group (35 subjects) and control group (34 subjects), wereanalyzed statistically. The mean pain (7.801.21 versus 9.051.11) and fatigue scores (46.5921 versus 123.3643.20) of the twogroups showed a statistically significant difference (P < 0.001). Moreover, the mean duration of the second stage in the interventiongroup was significantly higher than that in the control group (76.32 8.26 minutes versus 64.56 15.24 minutes, P = 0.001). Theumbilical cord blood pO2 levels of both groups showed a statistically significant difference (28.29 11.76 versus 18.83 9.86, P <0.001), whereas their pH levels were not significantly different (P = 0.10).Conclusions: Spontaneous pushing in the lateral position reduced fatigue and pain severity of the mothers. Also, it did not worsenfetal outcomes. Thus, it can be used as an alternative method for the Valsalva maneuver.
