The purpose of this study is to examine whether transperineal ultrasound as visual biofeedback can be used during labor as an effective tool for shortening the second stage of labor and reducing the need for instrumental delivery, in a prospective randomized design.
Biofeedback provides patients with better control of their body and their physiological reactions respective of the examined process, such as stress/anxiety, sports activity, labor, etc. Women under epidural anesthesia, may frequently feel lack of control over the birthing process and difficulty in bearing down effectively, which is a very significant part of the second stage of labor. Transperineal ultrasound during labor is a standard procedure in many medical centers in the world, mainly used to assist obstetricians in evaluating the progress of labor, fetal head position and assessing the chances of successful operative delivery. One of the most common tools used in transperineal ultrasound in measurement of the angle of progression, which has been suggested as a subjective method for assessing fetal station and for predicting successful vaginal delivery. A preliminary non-randomized study raised the possibility that the use of transperineal ultrasound during labor as a biofeedback tool may shorten the second stage of labor. The purpose of this study is to examine whether this tool can be used during labor as an effective tool for shortening the second stage of labor and reducing the need for instrumental delivery, in a prospective randomized design.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
100
Patient will observe the descent of the fetal head as they push during contractions
Assuta Ashdod Hospital
Ashdod, Israel
Duration of the second stage of labor
Minutes from first documentation of full dilatation to delivery.
Time frame: Up to 6 hours
Mode of delivery
Mode of delivery (categorical): spontaneous vaginal, operative vaginal or cesarean
Time frame: Up to 6 hours
Neonatal 1 minute Apgar score
Apgar score at 1 minute after delivery (scale of 0-10)
Time frame: Up to 6 hours
Neonatal 5 minute Apgar score
Apgar score at 5 minute after delivery (scale of 0-10)
Time frame: Up to 6 hours
Cord pH
Umbilical cord blood pH
Time frame: Up to 6 hours
Postpartum hemorrhage
Rate of early postpartum hemorrhage (during first 24 hours)
Time frame: Up to 24 hours
Maternal perineal tears
Maternal perineal tear grade (categorical): None and grades 1-4
Time frame: Up to 6 hours
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