Maternal and Perinatal Outcomes in Planned Labour: A Prospective Interventional Study

Abstract

Introduction: Labour, especially in primiparas, is associated with intense pain. Patients labouring without analgesia may experience longer durations in all stages, along with the suffering associated with labour pains. The study was conducted to determine whether a programmed labour regime provided adequate pain relief and accelerated the labour process. Aim: To compare the maternal and perinatal outcomes in patients who underwent conventional labour with those who received programmed labour analgesia. Materials and Methods: This prospective interventional study was conducted in the Department of Obstetrics and Gynecology at Netaji Subhash Chandra Bose Medical College and Hospital in Jabalpur, Madhya Pradesh, India. The study duration was one year and five months, from March 2021 to August 2022. A total of 100 patients, including 50 low-risk primiparas in each group with cervical dilatation of 3 to 4 cm, were randomly allocated to the case and control groups. The case group received a programmed labour regime, which involved administering small doses of various drugs such as pentazocine, drotaverine, diazepam, and tramadol. No analgesia was given to the control group. Pain relief assessment was conducted using a Visual Analogue Scale (VAS). The duration of the various stages of labour and the rate of cervical dilatation were assessed in both groups. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 23.0. Results: The mean age of the study subjects in the control group was 24.14±2.39 years, and in the case group, it was 24.26±2.49 years. Compared to the control group, 29 (58%) cases experienced mild pain, and 21 (42%) experienced moderate pain. The rate of cervical dilatation was 2.57±1.41 cm/hour in the case group compared to 1.41±0.36 cm/hour in the control group (p-value <0.001). The mean duration of the first (cervical dilatation from 3-4 cm onwards), second, and third stages of labour was 140.2±35.06 minutes, 25.22±9.41 minutes, and 3.56±0.91 minutes, respectively, in the case group. The duration of all stages of labour was significantly reduced in the case group (p-value <0.001). Minimal side effects were observed, with nausea being the most common side effect in 16% of cases. Conclusion: Programmed labour resulted in shorter and more comfortable labour with minimal adverse effects. This method does not require a trained anaesthetist; thus, it can be easily administered in low-resource settings.

Keywords

• cervical dilatation
• labour analgesia
• nausea
• pain relief