Effect of Peanut Ball and Position Changes in Women Laboring With an Epidural.
| Autor: | Hickey L, Savage J |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Nursing for women's health [Nurs Womens Health] 2019 Jun; Vol. 23 (3), pp. 245-252. Date of Electronic Publication: 2019 May 09. |
| DOI: | 10.1016/j.nwh.2019.04.004 |
| Abstrakt: | Objective: To examine the effect of a nurse-driven intervention using a peanut ball (PB) with position changes on length of labor and incidence of cesarean birth among women who receive epidural anesthesia. Design: Quasiexperimental comparison group design. Setting/local Problem: A 407-bed, nonprofit, Magnet-designated, Baby-Friendly Hospital Initiative-designated hospital with 8 labor and delivery suites and an average of 100 births per month. Participants: A total of 343 participants were included, with 164 women in the PB group. Intervention/measurements: The PB was placed after epidural administration; women were repositioned a minimum of every 1 to 2 hours, and the PB was removed at second stage of labor; duration was recorded. Results: Overall, women in the PB group were 50% less likely to have cesarean birth. For women with cervical dilation of 4 cm or less, rates of vaginal birth were 61% with use of the peanut ball. A multivariate analysis of outcomes was used. A multiple linear regression model showed, after adjusting for other variables, that PB placement alone did not shorten labor length (p = .4684). However, a stratified analysis indicated that for women with cervical dilation of 4 cm or less, length of the first stage of labor was affected by parity (p = .0042) and frequency of position change (p < .001). For women with cervical dilation greater than 4 cm, length of the first stage of labor was influenced by frequency of position changes (p = .0130) and effacement (p = .0050). Length of the second state of labor was affected by the frequency of position change (p = .0416). Conclusion: The PB may be an effective intervention to reduce the incidence of cesarean birth. Changing position frequently was associated with reduced length of first and second stages of labor. (Copyright © 2019 AWHONN. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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