Continuous Intrapartum Support to Reduce Primary Cesarean

Study Overview
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Brief Summary
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The objective of the study was to evaluate the intervention of intrapartum continuous support by a professional nurse with a university degree to reduce the nulliparous, term, singleton, vertex (NTSV) cesarean birth rate, in women pregnant less than 40 years in the HGZ No. 4 of the Guanajuato delegation of the Mexican Institute of Social Security, Mexico

Detailed Description
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Continuous intrapartum support is a strategy used to decrease the cesarean section rate, where multiple factors influence its effectiveness (start and duration of support, professional training of support staff, and others.). The objective of the study was to decrease the rate of deliveries by cesarean, through continuous intrapartum support during the active phase until birth, by a professional nurse with a university degree, the support was based on three basic aspects: 1) emotional support, 2) physical support and comfort measures and 3) information and counseling, for which a quasi-experimental study was conducted, with a study population of 115 women in labour (nulliparous, full-term, single product, vertex position) and under 40 years, a group control was formed (n = 55) who received routine maternal care and a study group (n = 60) who received continuous intrapartum support.

Official Title
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Continuous Intrapartum Support to Reduce Primary Cesarean

Conditions
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Cesarean Section Complications

Intervention / Treatment
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* Procedure: Continuous Intrapartum Support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women pregnant Nulliparous Term pregnancy Singleton pregnancy Vertex position Exclusion Criteria: Patients with maternal, fetal, or mixed cesarean indications were excluded.

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 40 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: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The control group was composed of women with labour, who attended the General Hospital of Zone 4 of the Guanajuato Delegation of the IMSS in the period of October-December 2016. The study group was composed of women with labour who presented at the same hospital to receive obstetric care in the period of October - December 2018.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Women in labor with continuous intrapartum support<br>Continuous intrapartum support was based on three basic aspects: 1) emotional support, 2) physical support and comfort measures and 3) information and advice. | Procedure: Continuous Intrapartum Support<br>* Received the usual obstetric care plus continuous intrapartum support that was provided by a Bachelor of Nursing and Obstetrics who received prior training by a professional doula.<br>|
| No Intervention: Women in labor without continuous intrapartum support.<br>The no intervention group received the usual obstetric care, without continuous intrapartum support. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cesarean delivery rate | Percentage de cesarean section in the arms | Until the occurrence of delivery (expected range from 6 hours to 12 hours) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time of labour | Labour covered the period of time from the active phase to birth. (Hours) | From the active phase up to delivery (expected range from 6 hours to 12 hours) | 
| Apgar score | Is a quick test performed on a baby at 1 and 5 minutes after birth | At 1 and 5 minutes after delivery | 
| Obstetric analgesia | If obstetric analgesia was applied to reduce the pain of labour. (Yes/No) If obstetric analgesia was applied to reduce the pain of labour. (Yes/No) | From the active phase up to delivery (expected range from 6 hours to 12 hours) | 
| Induction of labour | If oxytocin was used to induce labour. (Yes/No). | start of active phase (up to 1 hour) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cesarean section, Continuous intrapartum support, nulliparous