Childbirth is an energy-intensive physiological process, requiring sustained effort comparable in intensity to moderate physical activity. Studies suggest that providing an available energy source during labor, such as dextrose infusion or natural carbohydrate-rich foods such as dates, may shorten the duration of labor and improve cervical dilation without adversely affecting obstetric outcomes. The primary objective of the study is to examine whether giving chocolate during labor affects the duration of the second stage of labor, compared to a control group that will not receive a nutritional intervention. The study is a prospective, randomized, controlled trial that will be conducted in the delivery room of Hillel Yaffe Medical Center. Healthy pregnant women with a singleton pregnancy at ≥37 weeks gestational age, in spontaneous or induced labor, without diabetes (pre/gestational), will be recruited to participate. Participants in the intervention group will receive one serving of 50 grams of milk chocolate (cocoa content 25-30%, without filling or additives) at a cervical dilation of 6 cm or more (and not yet fully dilated). The mother will be asked to consume the serving gradually over 30 minutes. Milk chocolate was chosen because it is better tolerated compared to dark chocolate, has a more gentle profile of active ingredients (which can increase nausea and heartburn) and provides a source of available carbohydrates. The study will be conducted in accordance with the guidelines of the Ministry of Health's procedure for medical experiments on humans, and will be conducted after approval by the Institutional Helsinki Committee.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
180
Milk chocolate was chosen as it is better tolerated compared to dark chocolate, has a milder profile of active ingredients (which can increase nausea and heartburn) and provides a source of available carbohydrates. A dose of 50 grams was chosen that provides 25-30 grams of simple carbohydrates - sufficient for a significant increase in blood glucose but low enough to prevent a sudden sugar load or nausea. The intervention will be given at 6-9 cm dilation, towards the transition to the second phase - to allow the absorption of glucose and neurochemicals to be deafened at a time when the body needs increased energy and alertness. Giving it earlier may result in the effect of the chocolate wearing off before the second phase, and later - there will be no time for effective absorption.
Duration of second stage of labor
The duration of the second stage of labor, defined as the time in minutes from full cervical dulation (10cm) to delivery of the neonate.
Time frame: From full cervical dilation to delivery
Mode of delivery
Mode of delivery categorized as spontanous vaginal delivery, operative vaginal delivery (vacuum), or cesarean delivery
Time frame: At delivery
Maternal nausea or vomiting during labor
The occurrence of maternal nausea or vomiting during labor following the assigned intervention, as documented in the medical record
Time frame: From intervention administration untill discharge from labor room
Neonatal Apgar score at 1 and 5 minutes
The Apgar score is assessed at 1 and 5 minutes after delivery. The total score ranges from 0 to 10, with higher scores indicating better neonatal condition.
Time frame: 1 and 5 minutes after delivery
Umbilical cord blood glucose level
Umbilical cord blood glucose concentration measured from umbelical blood collected immediately after delivery (when a cord blood sample is obtained per routine practice
Time frame: at delivery
Maternal heart rate
Maternal heart rate measured in beats per minute as recorded by continous intrapartum maternal monitorind
Time frame: During the second stage of labor
Umbelical cord blood PH
Umbelical cord blood PH measures immediatley after delivery
Time frame: At delivery
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