Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia: A Randomized Clinical Trial.

ABSTRACT:

Importance

It is unclear whether the timing of second stage pushing efforts affects spontaneous vaginal delivery rates and reduces morbidities.

Objective

To evaluate whether immediate or delayed pushing results in higher rates of spontaneous vaginal delivery and lower rates of maternal and neonatal morbidities.

Design, setting, and participants

Pragmatic randomized clinical trial of nulliparous women at or beyond 37 weeks' gestation admitted for spontaneous or induced labor with neuraxial analgesia between May 2014 and December 2017 at 6 US medical centers. The interim analysis suggested futility for the primary outcome and recruitment was terminated with 2414 of 3184 planned participants. Follow-up ended January 4, 2018.

Interventions

Randomization occurred wh

SUBMITTER: Cahill AG 

PROVIDER: S-EPMC6583005 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature