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- W2332085849 abstract "Second stage lengths for mothers utilizing epidural anesthesia are longer than those not utilizing epidurals. One reason for prolonged second stage is reduced tactile sensation. Sensation serves as natural feedback of pushing efficacy. We wondered if auditory and visual feedback from precisely measured fetal decent could serve as a surrogate of maternal sensation. and would the feedback shorten the time to learn to push effectively. Measurement of fetal descent was accomplished using an optical sensor residing near the perineum. A wire affixed to a fetal scalp electrode was run through the optical device held in place by a rod mounted to the sacrum. As the head descends, the wire moves through the sensor measuring distance. Descent is reported graphically and audibly using piano tones in real time. This allows the mother to be cognizant of pushing efficacy even with eyes closed. Sixty-nine nulliparous women with epidurals were randomly assigned (2:1 ratio) to receive (Study) or not receive (Control) feedback from the device. Ten minute normalized graphical segments showing decent (graphically upward) were randomly displayed to evaluators blinded to the subject's Study or Control status. Pushing patterns of the segments were scored (0-4) as not effective through strongly effective. Mean scores were compared for the 1st hr. of pushing. Routine oral/digital feedback was allowed in both groups. Subjects receiving the feedback learned to push effectively in the first 10 minutes. In contrast, women without the feedback took 30 minutes to push as effectively. Figure 1 shows typical pushing patterns of Study (Feedback) and Control (No Feedback) subjects and Figure 2 shows mean scores over time. Real time precise measurement and feedback of fetal decent rapidly restores maternal ability to push effectively even when anesthetized. Such feedback might prove empowering and improve second stage outcomes by shortening the length of second stage labor." @default.
- W2332085849 created "2016-06-24" @default.
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- W2332085849 date "2015-01-01" @default.
- W2332085849 modified "2023-09-23" @default.
- W2332085849 title "260: Maternal auditory and visual feedback of precisely measured fetal decent improves pushing in women with regional anesthesia" @default.
- W2332085849 doi "https://doi.org/10.1016/j.ajog.2014.10.306" @default.
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