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There are several physiological advantages for being upright during labour. These include the effect of gravity on the fetus within the uterus; reduced risk of aorto-caval compression this maximizes uterine blood flow to the placenta and fetus during labour and more efficient contractions which lead to shorter first and second stage of labor. In addition, being upright during labour provide better alignment of the fetus; and increased pelvic outlet when the woman is in squatting and kneeling positions
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| study arm | Experimental | assumed upright position during first stage of labor |
|
| control arm | No Intervention | hospital routine care |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| assumed upright position during first stage of labor | Other | The study group assumed one of upright positions during first stage of labor, defined as walking , sitting, standing, kneeling & squatting positions ) |
| Measure | Description | Time Frame |
|---|---|---|
| Intensity of labor pain assessed by Visual analogue pain intensity scale | Assessment of labor pain assessed by VAS (Visual analogue pain intensity scale ).It is a self-reported 10 cm horizontal line which represented the subjective estimation of pain intensity. It comprised 0-10-point numerical scale, No pain (0), Mild pain (< 4), Moderate pain (4-6), Sever pain (7-10). | during the procedure |
| duration of first stage of labor | upright position may decrease the duration of first stage of labor | during the procedure |
| Measure | Description | Time Frame |
|---|---|---|
| duration of second stage of labor | upright position may decrease the duration of second stage of labor | immediately after intervention |
| fetal outcome | fetal well being through fetal heart rate assessment assessed by CTG (cardio toco graph ) machine |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of nursing Cairo university | Cairo | 11553 | Egypt |
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Allocation of the women to study or control group was carried out through a person not involved in the study nurses in charge during the shift. This allocation was concealed from person allocating a woman into the trial (nurses)
| during the procedure |
| Neonatal outcome | neonatal condition after delivery assessed by a standardized APGAR score tool by allocating scores to five simple criteria Activity (Muscle tone), Pulse (Heart rate), Grimace (reflex irritability) Appearance (Skin color) & Respiratory effort (breathing). A total score (0-3) revealed sever neonatal distress, (4-7) indicated moderate distress & (8-10) indicated absence of difficulty in adjusting to extra uterine live. | immediately after intervention |