Upright Position During First Stage of Labour

Study Overview
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Brief Summary
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There are several physiological advantages for being upright during labour. These include the effect of gravity on the fetus within the uterus; reduced risk of aorto-caval compression this maximizes uterine blood ﬂow to the placenta and fetus during labour and more efficient contractions which lead to shorter first and second stage of labor. In addition, being upright during labour provide better alignment of the fetus; and increased pelvic outlet when the woman is in squatting and kneeling positions

Official Title
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Effect of Upright Position During First Stage of Labour On Labour Outcome: An Evidence Based Approach

Conditions
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Effects of Movement

Intervention / Treatment
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* Other: assumed upright position during first stage of labor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primipara parturient women who admitted to delivery unit; in early active phase of 1st stage of labor (not more than 4cm), age between 20-35 years, had a single, viable, and full term (≥ 37 weeks), with normal fetal heart rate pattern (120-160 b/min), fetus in occipto anterior position free from medical or obstetrical disorders that may interrupt labor progress Exclusion Criteria: Any women out of inclusion criteria

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: study arm<br>assumed upright position during first stage of labor | Other: assumed upright position during first stage of labor<br>* The study group assumed one of upright positions during first stage of labor, defined as walking , sitting, standing, kneeling & squatting positions )<br>|
| No Intervention: control arm<br>hospital routine care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intensity of labor pain assessed by Visual analogue pain intensity scale | Assessment of labor pain assessed by VAS (Visual analogue pain intensity scale ).It is a self-reported 10 cm horizontal line which represented the subjective estimation of pain intensity. It comprised 0-10-point numerical scale, No pain (0), Mild pain (< 4), Moderate pain (4-6), Sever pain (7-10). | during the procedure | 
| duration of first stage of labor | upright position may decrease the duration of first stage of labor | during the procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| duration of second stage of labor | upright position may decrease the duration of second stage of labor | immediately after intervention | 
| fetal outcome | fetal well being through fetal heart rate assessment assessed by CTG (cardio toco graph ) machine | during the procedure | 
| Neonatal outcome | neonatal condition after delivery assessed by a standardized APGAR score tool by allocating scores to five simple criteria Activity (Muscle tone), Pulse (Heart rate), Grimace (reflex irritability) Appearance (Skin color) & Respiratory effort (breathing). A total score (0-3) revealed sever neonatal distress, (4-7) indicated moderate distress & (8-10) indicated absence of difficulty in adjusting to extra uterine live. | immediately after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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First stage of labor, Upright position, Labor outcomes