Women receiving audio-visual biofeedback of the fetal decent during delivery show reductions in the duration of the second stage of labour, as well as lower rates of adverse outcomes, researchers reported here today at The Pregnancy Meeting, the 2015 Annual Meeting of the Society for Maternal-Fetal Medicine (SMFM).
The common use of epidurals help reduce pain during labour, but the analgesia can impede pushing efficacy, resulting in a prolonged second stage, which is associated with adverse outcomes.
To evaluate how a real-time feedback system providing precise measurement of fetal decent could affect the duration of delivery time, Bardett Fausett, MD, Women’s and Children’s Hospital, Lafayette, Louisiana, and colleagues evaluated 69 women receiving epidural anaesthesia during delivery.
The women were randomised 2 to 1 to receive feedback from the device measuring and conveying sub-second and submillimetre intervals or no feedback.
The results showed that among women who did receive feedback (n = 45), the median pushing time was 58 minutes, compared with 77 minutes for the non-feedback group.
In the lower three quartiles of the feedback group, the length of the second stage was reduced by 23 minutes (26%; P = .016).
In addition, adverse outcomes from operational vaginal delivery, third or fourth degree laceration, intra-amniotic infection and perineal oedema were all lower in the group receiving biofeedback (P< .02 for all).
While there was no difference in rates of caesarean section deliveries between the groups, the biofeedback group had composite adverse outcomes that were 73% lower than the non-feedback group (P = .011).
“We now know that use of this feedback system improves maternal pushing increasing the chances of a spontaneous vaginal delivery and decreasing key adverse maternal outcomes such as perineal trauma,” said Dr. Fausett said in a press statement. “The system also decreases neonatal intensive care admissions.”