Spontaneous and active pushing in second stage labor and fetal outcome in primiparous women

Abstract

BACKGROUND AND OBJECTIVE: Active pushing in second stage labor is acceptable, despite its complications for fetus and it has been noticed by midwifes and obstetricians. Recent studies have shown that spontaneous pushing decreases fetal acidosis. So, the objective of this study was to assess the effect of spontaneous and active pushing in second stage labor on fetal outcome in primiparous women.METHODS: This clinical trial study was done on 108 primiparous women with uncomplicated labor that based on fliess table randomly assigned to spontaneous and active groups. In spontaneous group used her own urge to push and in active groups encouraged to take a deep breath, hold it and push for ten numbers. After delivery, cord arterial blood PH value and Apgar score (1min & 5min) were measured.FINDINGS: The results of this study showed that arterial cord PH was higher in the spontaneous pushing versus active pushing (p<0.001). Apgar score (1min & 5min) had no significant difference between two groups. There was significant correlation between Apgar score (1min & 5min) and arterial umbilical PH (p=0.028, p=0.019).CONCLUSION: Spontaneous pushing decreases fetal acidosis so it can be effective, healthy, and cheap method for improving neonatal outcome.

Keywords

• spontaneous pushing
• active pushing
• second stage labor
• fetal outcome