Urinary Catheterization and Second Stage of Labor

Study Overview
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Brief Summary
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Labor is divided into three stages: the first stage is from labor onset until full dilation, second stage is from full dilation until delivery of the baby, and the third stage from the delivery of the baby until the delivery of the placenta The mean duration of second stage in nulliparas as defined by the American college of obstetricians and gynecologists (ACOG) is 54 minutes Epidural anesthesia is a known cause for prolongation of the second stage of labor. Prolonged second stage in nullipara women with epidural is defined as more than 3 hours, and more than 2 hours in those without epidural. Although perinatal outcome is not compromised with a prolonged second stage , there is evidence that maternal morbidities such as perineal trauma, chorioamnionitis ,instrumental delivery and postpartum hemorrhage increase with prolonged second stage Another effect of epidural anesthesia during labor is urinary retention and a need for catheterization. Full bladder may behave as a tumor previa and interfere to fetal head descent in the birth canal, increasing by that the duration of the second stage. This study aims to investigate the effect of intermittent versus continuous catheterization on the duration of the second stage of labor

Official Title
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Effect of Intermittent Versus Continuous Bladder Catheterization During Labor on Second Stage Duration

Conditions
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Labor, Second Stage

Intervention / Treatment
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* Other: urinary catheterization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Nulliparous women Gestational age 24-42 weeks epidural anaesthesia Vertex presentation Singleton Exclusion Criteria:

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: intermittent urinary catheterization<br>nullipara women with epidural anaesthesia who pose urination difficulty will receive intermittent catheterization | Other: urinary catheterization<br>* nullipara women with epidural anaesthesia who pose urination difficulty will be randomize to receive intermittent or continuous urinary catheterization.<br>* Other names: continuous versus intermittent catheterization.;|
| Active Comparator: continuous urinary catheter<br>nullipara women with epidural anaesthesia who pose urination difficulty will receive continuous catheterization | Other: urinary catheterization<br>* nullipara women with epidural anaesthesia who pose urination difficulty will be randomize to receive intermittent or continuous urinary catheterization.<br>* Other names: continuous versus intermittent catheterization.;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| duration of second stage of labor |  | within the first 48 hours after delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| chorioamnionitis |  | within the first 48 hours after delivery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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urinary catheterization, duration of second stage, epidural anaesthesia