806: Virtual reality may decrease pain during labor

Abstract

across three groups: small-for-gestational age (SGA) (BW <10%ile), appropriate-for-gestational age (AGA) (BW 10-90%ile), and largefor-gestational age (LGA) infants (BW >90%ile), with SGA as the reference group. Interval-censored regression estimated median duration of labor stratified by actual BW, as well as by labor type (spontaneous vs. induction) and parity (nulliparity vs. multiparity). RESULTS: Of 17,099 women, 5970 (34.9%) were induced and 6,457 (37.8%) were nulliparous; 2,457 (14.4%) and 908 (5.3%) women delivered SGA and LGA infants, respectively. After adjustment for obesity, epidural and prior cesarean, SGA infants progressed through labor significantly faster than AGA and LGA infants. Median time to dilate 4-10cm was 4.0 (5-95 th percentile, 1.2-13.4), 4.6 (1.4-15.6, p¼0.07), and 6.2 (1.8-21.1, p<0.01) hours in the SGA, AGA and LGA groups, respectively. Median time in active labor (6-10cm) was 1.1 (0.2-5.9), 1.6 (0.3-8.4, p<0.01) and 2.1 (0.4-11.3, p<0.01) hours in the SGA, AGA and LGA groups, respectively. Median time to progress 4-6cm was similar in SGA and AGA infants overall (p¼0.13), and remained similar for nulliparous women (p¼0.37) and labor induction (p¼0.34). Median time to progress 4-6cm was longer with LGA infants than with SGA infants overall (p<0.01) and when stratified by labor type (p<0.01) and parity (p<0.01). The difference in median time to dilate 6-10cm remained significant among all three BW groups even when stratified by labor type (p<0.01) and parity (p<0.01). CONCLUSION: After reaching 4cm cervical dilation, SGA infants have similar labor progression as AGA infants, particularly among nulliparous and induced women, but have faster progression compared to LGA infants until the active phase of labor is reached. SGA infants progress through active labor faster than AGA and LGA infants, irrespective of labor type and parity. Clinicians should consider fetal size when monitoring first stage labor progress and determining labor arrest.

A randomised controlled trial to assess the feasibility of utilising virtual reality to facilitate analgesia during external cephalic version

“…One of the cornerstones of healthcare improvement, as formulated by the Institute of Healthcare Improvement, is with respect to the enhancement of patient experience 32 . In this regard, the findings of our pilot remain promising and in-line with other pregnancy-related studies which have demonstrated a high level of www.nature.com/scientificreports www.nature.com/scientificreports/ maternal satisfaction and acceptability for VR, with approval ratings between 77-82% 17,33 . This alludes to women being interested in and welcoming the addition of the technological medium into their pregnancy care.…”

Virtuální realita v porodní asistenci jako nefarmakologická metoda

“…Ze studií (10,11,1,12,13) vyplývá pozitivní vliv virtuální reality jako nefarmakologické metody v péči o ženy s porodní bolestí v I. době porodní, ale i při ošetření epiziotomie a v poporodním období. Ženy při využití této metody hodnotily pozitivněji zvládání samotného porodu, porodní bolesti a byly více spokojeny s péčí porodní asistentky, zdravotnického personálu.…”

“…Ženy při využití této metody hodnotily pozitivněji zvládání samotného porodu, porodní bolesti a byly více spokojeny s péčí porodní asistentky, zdravotnického personálu. Data ukazují, že významným faktorem podílejícím se na rozvoji porodní bolesti je strach a úzkost (10).…”

“…Zjištěné výsledky z literární review (10,1,12,13,14) ukazují, že virtuální realita může být potencionálně efektivní jako nefarmakologická při péči o ženy s porodní bolestí.…”

“…Důvodem bylo, že v aktivní fázi porodu vnímaly ženy porodní bolest intenzivněji. Studie Ebrahimzadeha (11) potvrdila stejné výsledky v péči o rodící ženy jako studie Freye (1) a Cowlese (10). Krom toho studie poukázala na efekt VR při ošetření epiziotomie.…”