Programmed Labor—Indegenous Protocol to Optimize Labor Outcome

Abstract

Objective To Asses and develop an indigenous protocol to optimize labour outcome, as Programmed Labor. Design Open, prospective (Between January 2000 to December 2007), randomized, parallel group, monocentric, comparative matching trial. Settings Labor rooms at Nowrosjee Wadia Maternity, Mumbai. Selection criteria 200 patients in each group, aged between 21-30, as low-risk parturient. Intervention Partography, Oxytocin, Primiprost, Pentazocin, Dizepam, Tramadol, Drotin, Ketamine. Outcome parameters Satisfactory obstetric outcome, progressive labor of shorter duration, less blood loss and pain relief. Results Study group had mean shorter duration of active labor as 3.5 hrs compared to controls of 5.2 hrs. Excellant pain relief was of 24 and 62% of substantial relief in comparison to 32% only in other group with no patient falling in excellent group. Second stage of labor was reduced by half (26 to 48 meters) and lesser third stage blood loss. Conclusions Programmed labor with indigenous protocol developed and practiced, results in progressive, shorter, and comfortable labors with lesser blood loss.

A comparative study of the effects of programmed labour protocol and expectant management of labour

“…6 Daftary SN et al and Jyoti M et al also noted less blood loss in their patients managed by programmed labour. 4,7 In this study, 25% had good pain relief, 60% had moderate pain relief, 15% had mild pain relief and 0% had no pain relief. Good relief of pain in 37%, moderate relief in 48% and mild pain relief in 15% was found in the study by Mir S et al 8 Daftary SN et al noted excellent pain relief in 70%, substantial relief in 62% and insufficient pain relief in 14% of their study group; they had additionally used inj.…”

“…Ketamine when required. 4 Jyoti M et al noted good pain relief in 54% and Manoj A et al in 70% of their study cases. 7,9 Vaginal delivery rate was higher 91.67% in present study group with faster cervical dilatation, may be due to Drotavarine and pain relief achieved by programmed labour.…”

“…Daftary SN et al had a mean total duration of labour of 239.5 minutes in their study patients. 4 Blood loss was also found to be significantly less than with expectant management. Mean blood loss among group A in this study was 89.33±19.06 ml.…”

“…Drotaverine) in this protocol were the same as those used in various other studies on this protocol. 4,6,9 They have been found to be devoid of any major side effects in mothers as well as babies.…”

“…4 The protocol developed by Daftary et al at the Nowrosjee Wadia Maternity Hospital, Mumbai over a period of many years rests on the three pillars of ensuring adequate uterine contractions, providing optimum pain relief and close clinical monitoring of labour events with a Partograph.…”