The Maternal and Perinatal Outcomes Associated With the Use of Non-pharmacological in Labor
Condition: Pain
Study type: Interventional

Summary: 
      Although there are studies that investigated the use of non-pharmacological pain relief and
      correction of dystocia during labor, there are few randomized controlled trials, especially
      related to combined protocols that use such resources. The use of combined protocols could
      potentiate the effects of resource use alone, evidencing the need for more studies related to
      the topic, as well as the effects of these methods on maternal and perinatal outcomes. In
      order to verify the effect of these methods in various stages of labor, childbirth and
      immediately becomes necessary to conduct a randomized controlled trial well-designed and
      adequate sample size that can make the future systematic reviews that can definitely conclude
      about the potential effectiveness of protocols that use combined resources to
      non-pharmacological pain relief in labor. Aim of our study is to evaluate the effects of a
      protocol of non-pharmacological resources on pain of pregnant women in the active phase of
      cervical dilatation and compared with controls.
    

Detailed description: 
      Labor is a natural physiologic process triggered by mechanical and hormonal events that
      promote uterine contractions. Several non-pharmacological resources can be used during labor,
      such as relaxation techniques and ongoing support, maternal mobility, walking, breathing
      exercises, massage, Swiss ball, stool, shower, whirlpool and application of transcutaneous
      electrical stimulation (ENT .) Despite the role of physiotherapy in labor is not an
      established practice in public hospitals, it is expected that with the evidence of the
      benefits of non-pharmacological resources at this time, managers and health professionals
      validate the importance of interdisciplinary care in pregnancy - postpartum. The aim of this
      study is to evaluate the effects of resources on non-pharmacological pain of mothers in the
      active phase of cervical dilatation when compared to controls. This research is a randomized,
      controlled clinical study that includes pregnant women randomly assigned to two groups:
      Intervention Group (IG) women who will use the following sequence features: ambulation (with
      cervical dilatation of 4 to 5 cm), alternating stance associated with ENT (cervical
      dilatation from 6 to 7 cm) and a shower (with dilation> 7 cm) for 40 minutes each resource;
      Control Group (CG) women who will not use any physical therapy resource, are subject only to
      routine procedures of maternity care . For pain assessment will use the Visual Analogue Scale
      - VAS and the body diagram of the location and spatial distribution of pain. Results are
      presented in tables and graphs made to better understand the comparisons between the control
      and intervention. To compare maternal morbidity, obstetric and neonatal between groups will
      be used Fisher's exact test or chi-square.
    

Intervention name(s): Use of non-pharmacological; Other: Routine care
Intervention type(s): Other; Other
Intervention description(s): Other: Non-pharmacological resources
A sequence of non-pharmacological resources were applied to the patient by the researcher according to uterine cervical dilation, as follows:
Walking (with cervical dilation between 4 and 5 cm)
Alternating stance associated with ENT (cervical dilatation from 6 to 7 cm)
Shower (with dilation> 7 cm);; Other: Routine care Routine care of the institution performed by the staff, without the presence of the researcher that included offering a balanced meal, continuous support with the presence of a partner or family throughout labor, use of oxytocin when prescribed by the staff, use of drug analgesia when requested by the patient.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Labor; vaginal delivery; pain