Comparative study of programmed labor and traditional management of labor

Abstract

Background: Prolongation of labor leads to dehydration, ketoacidosis, infection, fetal asphyxia. Programmed labor aims at reducing the duration of labor, labor pain and incidence of cesarean section with improved maternal and neonatal outcome. Aims and Objectives: 1)To evaluate the effect of programmed labor on duration of labor. 2)To assess efficacy of analgesics in reducing pain of labor. 3)To find out maternal and neonatal complications. 4)To study impact of programmed labor on LSCS rates. Methods: Prospective randomized study of primigravida in active labor (after 4 cm cervical dilatation) for which 100 women were selected for programmed labor (cases) and 100 women were selected for traditional management of labor (controls). Cases were subjected to interventions to improve uterine contractions (ARM, Dinoprostone tablets, and Oxytocin drip), to facilitate cervical dilatation (Inj. Drotaverine), to relieve labor pains (Inj. Pentazocine & Diazepam). All labors were monitored by partogram. Results: Programmed labor reduced duration of first and second stage of labor. There was faster cervical dilatation (1.8 cm/hour against 1.2 cm/hour). Majority of the patients had better pain relief. There was no impact on LSCS rates Conclusions: Programmed labor significantly reduced duration of labor with good pain relief without compromising maternal and fetal/neonatal safety. But it had no impact on LSCS rates. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000): 209-212

Quest for Labor Analgesia in Second Stage in Resource Poor Setup

“…12 There was no statistically significant difference in the Apgar score between the study group and the control group and all the newborns in both groups had satisfactory Apgar scores. Similar findings were observed by Daftary et al and Kshirsagar et al 2,14 In this study, no maternal complications were observed immediately, 24 hours and 1 week after giving PNB. Kshirsagar et al reported drug-related side effects like nausea, vomiting, and drowsiness that subsided after 12 hours, hypertonic contractions (5%).…”

“…The studies, where the combination of parenteral opioids and antispasmodic was used as labor analgesia, the percentage of instrumental delivery was found to be higher than the present study. 2,3,14 Mousa et al and Fan et al reported that 87.5% and 83.33% patients had normal vaginal delivery, 5%, and 10% had instrumental delivery and 7% and 6.67% had cesarean section respectively. They had used epidural anesthesia as labor analgesia.…”

“…Kshirsagar et al reported drug-related side effects like nausea, vomiting, and drowsiness that subsided after 12 hours, hypertonic contractions (5%). 14 Joel et al reported side effects of ketamine such as nystagmus in 5.71% parturients and light-headedness in 48.5%. 12 Although the limitation of this study is small sample size but the strength of this study is that second stage analgesia has been studied separately.…”