Self-motivated pushing for normal birth in the second stage of labour Pregnancy and Childbirth
Conditions
Interventions
Patients admitted to the ward for planned vaginal delivery and who fulfil the study criteria after initial assessment will be approached for recruitment. A participant information sheet will be given
Sponsors
University Malaya Medical Centre
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: 1. Age = 18 years old 2. Nulliparous (no pregnancy after 20 weeks) 3. Singleton pregnancy 4. Cephalic presentation 5. No contraindication for vaginal delivery 6. Term = 37 weeks 7. Reassuring fetal heart rate tracing 8. About to commence pushing for vaginal delivery
Exclusion criteria
Exclusion criteria: 1. Known major fetal anomaly 2. Planned instrumental delivery to shorten the second stage 3. Planned episiotomy 4. Maternal visual impairment (e.g., legally blind) 5. History of maladaptive maternal response to visual stimuli (e.g., migraine, seizure provoked) 6. Significant vulval-vaginal surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Major birth injury (second-degree or more severe perineal tear, or caesarean delivery) measured using data documented in the participant’s hospital chart after randomisation | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Duration of active second stage of labour measured using data documented in the participant’s hospital chart from the activation of biofeedback during active pushing to delivery (as contemporaneously recorded) 2. Maternal satisfaction with birth experience measured using scoring from 0 to 10 on a Numerical Rating Scale (NRS) before hospital discharge 3. Maternal outcomes measured using data retrieved from the patient’s electronic medical charts at hospital discharge: 3.1 Mode of delivery 3.2 Indication of operative delivery (operative vaginal and caesarean) 3.3 Estimated blood loss during delivery 3.4 Degree of perineal injury 4. Neonatal outcomes measured using data retrieved from the patient’s or offspring’s electronic medical charts at hospital discharge: 4.1 Birth weight 4.2 Umbilical cord arterial blood pH and base excess at birth 4.3 Apgar score at 1 and 5 minutes of life 4.4 Special care nursery/ neonatal intensive care unit admission during birth admission 4.5 Indication for neonatal admission 5. Major harms measured using data retrieved from the patient’s or offspring’s electronic medical charts at hospital discharge: 5.1 Hypoxic-ischaemic encephalopathy (neonatal) 5.2 Maternal admission to ICU for trauma sustained at birth | — |
Countries
Malaysia
Contacts
Public ContactProf. Dr. Tan Peng Chiong
Outcome results
None listed