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Labor down

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Babak Jebelli
Babak Jebelli
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“ LABORING DOWN” Passive Descent Delayed Pushing Small Randomised Controlled Trials with Different outcome measures & variable amounts of “time for delay before pushing” have created fuel for passionate positions
ACOG PRACTICE BULLETIN 2003 No 49 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Laboring Down” WHAT IS THE EVIDENCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multicenter, randomized, controlled trial of delayed pushing for Nulliparous women in the second stage of labor with Continuous Epidural Analgesia . Am J Obstet Gynecol 2000;182:1165 (n = 1862) (1994-1996) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multicenter, randomized, controlled trial of delayed pushing for Nulliparous women in the second stage of labor with Continuous Epidural Analgesia . Am J Obstet Gynecol 2000;182:1165 (n = 1862) (1994-1996) MEDIAN DELAY ~ 2 HOURS ( 40 % > 2 HRS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
A Meta-Analysis of passive descent versus immediate pushing in Nulliparous women with Epidural analgesia in the second stage of labor. J Obstet Gynecol Neonatal Nurs. 2008 Jan-Feb;37(1):4-12. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Candidates for Delayed Pushing Maximum delay 90 minutes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Labor Down Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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