Complementary therapies in labor: randomized clinical trial

Cavalcanti, Ana Carolina Varandas; Henrique, Angelita José; Brasil, Camila Moreira; Gabrielloni, Maria Cristina; Barbieri, Márcia

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Revista Gaúcha de Enfermagem

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Brasil

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Original Article • Rev. Gaúcha Enferm. 40 • 2019 • https://doi.org/10.1590/1983-1447.2019.20190026 copy

Complementary therapies in labor: randomized clinical trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE:

To evaluate the effect of isolated and combined warm shower bath and perineal exercise with Swiss ball, on perception of pain, anxiety and labor progression.

METHOD:

Randomized, controlled clinical trial with 128 patients allocated into three groups of therapies: isolated and combined bath and ball. Pain and anxiety perception was evaluated before and thirty minutes after therapeutic intervention through visual analogic scales (VAS).

RESULTS:

Pain perception score increased, and anxiety decreased in all groups, mainly when using a shower bath. The cervical dilation increased in all groups (p<.001), as well as the number of uterine contractions increased, mainly in the group that used combined bath and ball and also showed shorter labor time.

CONCLUSION:

The studied therapies contribute to maternal adaptation and well-being and favor labor’s evolution.

Keywords:
Anxiety; Hydrotherapy; Labor pain; Labor obstetric; Complementary therapies; Obstetric nursing

Variable	Total	Hot Bath	Swiss Ball	Hot Bath and Swiss Ball	p
Age (years, mean, SD)	26.02 (5.73)	26.05 (5.41)	27.24 (6.47)	24.56 (4.91)	0.101^b
Color	127 (100.0%)	44 (100.0%)	45 (100.0%)	38 (100.0%)	0.157^a
Caucasian	61 (48%)	25 (56.8%)	19 (42.2%)	17 (44.7%)
Black	13 (10.2%)	5 (11.4%)	6 (13.3%)	2 (5.3%)
Asian	5 (3.9%)	1 (2.3%)	0 (0.0%)	4 (10.5%)
Brown-skinned	48 (37.8%)	13 (29.5%)	20 (44.4%)	15 (39.5%)
Schooling	127 (100.0%)	44 (100.0%)	45 (100.0%)	38 (100.0%)	0.644^a
0 to 3 years	1 (0.8%)	1 (2.3%)	0 (0.0%)	0 (0.0%)
4 to 7 years	11 (8.7%)	4 (9.1%)	3 (6.7%)	4 (10.5%)
8 to 11 years	89 (70.1%)	27 (61.4%)	34 (75.6%)	28 (73.7%)
12 or more	26 (20.5%)	12 (27.3%)	8 (17.8%)	6 (15.8%)
Gestational age (weeks; mean, SD)	39.69 (1.06)	39.69 (1.02)	39.78 (1.17)	39.60 (1.00)	0.731^b
Number of pregnancies (mean, SD)	2.01 (1.25)	1.95 (1.36)	2.24 (1.33)	1.79 (0.98)	0.193^c
Parity (mean, SD)	0.71 (0.97)	0.75 (1.16)	0.80 (0.92)	0.56 (0.75)	0.517^c
Number of visits (mean, SD)	8.37 (1.98)	8.86 (2.31)	8.22 (1.96)	7.97 (1.48)	0.098^b
First prenatal visit (quarter)
1st	96 (75.0%)	34 (77.3%)	32 (71.1%)	30 (76.9%)
2nd	31 (24.2%)	9 (20.5%)	13 (28.9%)	9 (23.1%)
3rd	1 (0.8%)	1 (2.3%)	0 (0.0%)	0 (0.0%)
Time of intervention at birth (minutes, mean, SD)	253.43 (153.53)	255.05 (148.00)	288.41 (188.32)	216.85 (124.28)	0.102^b
Presence of companion	128 (100.0%)	44 (100.0%)	45 (100.0%)	39 (100.0%)	0.874^a
Yes	115 (89.8%)	39 (88.6%)	40 (88.9%)	36 (92.3%)
No	13 (10.2%)	5 (11.4%)	5 (11.1%)	3 (7.7%)

	Intervention			p¹
Variable	Hot Bath	Swiss Ball	Hot Bath and Swiss Ball
Pain
Before	7.55 (1.74)	7.56 (1.90)	7.54 (1.71)	0.999
After	8.38 (1.79)	8.02 (1.83)	8.08 (2.19)	0.594
Difference	0.83 (1.44)	0.47 (1.87)	0.54 (1.93)	0.663
p²	0.001	0.127	0.077
Anxiety
Before	7.75 (2.69)	8.76 (2.07)	7.54 (3.15)	0.084
After	7.52 (2.78)	8.44 (2.09)	7.49 (3.02)	0.217
Difference	-0.23 (1.43)	-0.31 (1.55)	-0.05 (1.96)	0.883
p²	0.291	0.216	1.000
Cervical dilatation (cm)
Before	4.86 (1.03)	4.96 (1.24)	5.13 (1.30)	0.706
After	6.41 (1.50)	6.16 (1.68)	6.69 (2.02)	0.369^a
Difference	1.55 (1.21)	1.20 (1.22)	1.56 (1.31)	0.208
p²	<0.001	<0.001	<0.001
Number of contractions in cardiotocography in 20 minutes
Before	2.77 (0.84)	3.13 (0.86)	3.19 (1.26)	0.213
After	3.03 (0.75)^A	3.33 (0.90)	3.47 (0.76)^B	0.042
Difference	0.26 (0.82)	0.21 (0.83)	0.28 (1.30)	0.610
p²	0.071	0.124	0.150

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[1] Corresponding author
: Ana Carolina Varandas Cavalcanti E-mail: acvcavalcanti@hotmail.com