Medication used in Denmark in the latent phase of labor – Do we know what we are doing?

Glavind, Julie; Grève, T.; Wolff, Mie Gaarskjaer de; Hansen, Mette Kabell; Henriksen, Tine Brink

doi:10.1016/j.srhc.2020.100515

Cited by 4 publications

(12 citation statements)

References 13 publications

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“…We screened 2228 titles and abstracts. Of those, 46 papers were subjected to detailed evaluation in full-text screening,4 6 20–63 and 14 met inclusion criteria 4 6 20–31. The main reasons for exclusion were an inadequate method of reporting prevalence of polypharmacy or reporting on specific subpopulation of pregnant women.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of polypharmacy in pregnancy: a systematic review

et al. 2023

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ObjectivesThe use of medications among pregnant women has been rising over the past few decades but the reporting of polypharmacy has been sporadic. The objective of this review is to identify literature reporting the prevalence of polypharmacy among pregnant women, the prevalence of multimorbidity in women taking multiple medications in pregnancy and associated effects on maternal and offspring outcomes.DesignMEDLINE and Embase were searched from their inception to 14 September 2021 for interventional trials, observational studies and systematic reviews reporting on the prevalence of polypharmacy or the use of multiple medications in pregnancy were included.Data on prevalence of polypharmacy, prevalence of multimorbidity, combinations of medications and pregnancy and offspring outcomes were extracted. A descriptive analysis was performed.ResultsFourteen studies met the review criteria. The prevalence of women being prescribed two or more medications during pregnancy ranged from 4.9% (4.3%–5.5%) to 62.4% (61.3%–63.5%), with a median of 22.5%. For the first trimester, prevalence ranged from 4.9% (4.7%–5.14%) to 33.7% (32.2%–35.1%). No study reported on the prevalence of multimorbidity, or associated pregnancy outcomes in women exposed to polypharmacy.ConclusionThere is a significant burden of polypharmacy among pregnant women. There is a need for evidence on the combinations of medications prescribed in pregnancy, how this specifically affects women with multiple long-term conditions and the associated benefits and harms.Tweetable abstractOur systematic review shows significant burden of polypharmacy in pregnancy but outcomes for women and offspring are unknown.PROSPERO registration numberCRD42021223966.

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Section: Resultsmentioning

confidence: 99%

Prevalence of polypharmacy in pregnancy: a systematic review

et al. 2023

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“…The duration of labor was significantly longer in the group of women who were treated with therapeutic rest than in the group of women who were not (median [IQR], hours; 45.5 [31-60.5] vs 25.3 [18-34.5]). Furthermore, women who were treated with therapeutic rest had a significantly longer duration from the time of seeking care at the labor ward in the latent phase to delivery (median [IQR], hours; 22 [14.5-31] vs 12.5 [8][9][10][11][12][13][14][15][16][17][18][19]). Median time interval from administration of medication to delivery among women treated with therapeutic rest was 20 hours (IQR 13-28).…”

Section: Re Sultsmentioning

confidence: 99%

“…and/or tocolytics (terbutaline, nifedipine); however, the composition of the medication for therapeutic rest varies between hospitals. 8,13 We found no international guidelines on the use of therapeutic rest.…”

Section: Introductionmentioning

confidence: 98%

“…[4][5][6][7] Most often, advice about non-pharmacological interventions such as showers, relaxation and massage is given, and if these measures are not considered sufficient, midwives can decide to offer the woman therapeutic rest. 8 In this study we define therapeutic rest such as use of morphine, other opioid or opioid analogs, and/or sedative medication, alone or in combination with simple analgesics to relieve pain, exhaustion or anxiety, and to attain rest or sleep and used in the latent phase. [9][10][11] In Denmark, along with other Nordic countries, up to 21% of all pregnant women are treated with therapeutic rest during labor consisting of mild analgesics, opioid analgesics and hypnotics/sedatives in various predefined combinations.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, despite its common use, data and knowledge regarding both the safety and the effect of combined medication for therapeutic rest remain limited. 8 The objectives of this study were to compare perinatal and labor outcomes in women who were seeking hospital care during the latent phase of labor and who were treated either with or without therapeutic rest.…”

Section: Introductionmentioning

confidence: 99%

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Perinatal outcomes after therapeutic rest in the latent phase of labor: A cohort study

Bagger,

Milidou,

Boie

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionTherapeutic rest refers to the usage of medication to relieve pain in women in the latent phase of labor. Very few data are available to evaluate the safety and effect of its use.The objectives of this study were to compare perinatal and labor outcomes in women who were seeking hospital care during the latent phase of labor and who were treated either with or without therapeutic rest.Material and methodsRetrospective cohort study with inclusion of nulliparous singleton pregnant women in the latent phase of labor presenting at the labor ward at Aarhus University Hospital, Denmark from May 13, 2018 to June 1, 2021. We identified two groups: women who were treated with therapeutic rest and women who were not. The primary outcomes were neonatal admission and neonatal resuscitation. Secondary outcomes included use of cardiotocography during labor, nonreactive fetal heart rate, meconium‐stained amniotic fluid, pediatric delivery room assistance, umbilical cord arterial pH and standard base excess, Apgar score at 5 minutes, interventions during labor and mode of delivery.ResultsIn our sample of 800 women in the latent phase of labor, 414 women (52%) were treated with therapeutic rest and 386 women (48%) were not. The most frequently used (n = 206) medication for therapeutic rest was a combination of paracetamol, triazolam and codeine. We found no significant difference in neonatal admission (9.2% vs 6.5%, adjusted odds ratio [aOR] 1.2, 95% confidence interval [CI] 0.4–3.1) or neonatal resuscitation (2.4% vs 3.1%, aOR 0.7, 95% CI 0.1–4.0) between women treated with or without therapeutic rest. There were no differences between the two groups in other perinatal adverse outcomes, interventions during labor or mode of delivery.ConclusionsThis study found no significant association between therapeutic rest and neonatal admission or resuscitation. Our findings indicate that therapeutic rest is a safe method for managing the latent phase of labor concerning neonatal health and does not increase the risk of labor complications.

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Medication used in Denmark in the latent phase of labor – Do we know what we are doing?

Cited by 4 publications

References 13 publications

Prevalence of polypharmacy in pregnancy: a systematic review

Prevalence of polypharmacy in pregnancy: a systematic review

Perinatal outcomes after therapeutic rest in the latent phase of labor: A cohort study

Therapeutic rest in early labor may adversely affect the risk of neonatal admission

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