Integrated Intrapartum Supportive Care and Pushing Strategies in Women Receiving Low-Dose Epidural Analgesia
17 de junio de 2026 actualizado por: Wan-Lin Pan, National Taipei University of Nursing and Health Sciences
Integrated Intrapartum Supportive Care Combined With Different Pushing Strategies Among Women Receiving Low-Dose Epidural Analgesia: A Three-Arm Non-Randomized Quasi-Experimental Study
This prospective, three-arm, non-randomized quasi-experimental study aims to evaluate integrated intrapartum supportive care combined with different pushing strategies among women at 37-42 weeks of gestation who receive low-dose epidural analgesia.
Participants receive integrated intrapartum supportive care combined with spontaneous pushing, integrated intrapartum supportive care combined with immediate pushing, or routine intrapartum care combined with immediate pushing.
The primary outcomes are the durations of the first and second stages of labor.
Secondary outcomes include mode of birth, obstetric interventions, maternal outcomes, and neonatal outcomes.
Descripción general del estudio
Estado
Reclutamiento
Descripción detallada
Participants are enrolled into one of three predefined care groups: (1) integrated intrapartum supportive care combined with spontaneous pushing (IC-SP), (2) integrated intrapartum supportive care combined with immediate pushing (IC-IP), or (3) routine intrapartum care combined with immediate pushing (RC-IP).
Group allocation is determined prospectively according to the attending physician's established clinical practice.
The RC-IP group receives the hospital's usual intrapartum care.
Allocation is determined before implementation of the intervention and is not based on labor outcomes.
Tipo de estudio
Intervencionista
Inscripción (Estimado)
159
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Estudio Contacto
- Nombre: Wan-Lin Pan, PhD
- Número de teléfono: +886-2-2822-7101 ext. 7101
- Correo electrónico: wanlimp@gmail.com
Ubicaciones de estudio
-
-
-
Taipei, Taiwán, 10556
- Reclutamiento
- Taiwan Adventist Hospital
-
Contacto:
- Wan-Lin Pan
- Número de teléfono: 0933710737
- Correo electrónico: wanlimp@gmail.com
-
-
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
No
Descripción
Inclusion Criteria:low-risk pregnant women aged 18 years or older with a singleton, term pregnancy (37-42 weeks), spontaneous labor onset, and planning to receive low-dose epidural analgesia.
Exclusion Criteria: Exclusion Criteria: multiple gestation, non-cephalic presentation, known major fetal anomalies, planned cesarean birth, contraindications to vaginal birth, contraindications to maternal mobility or epidural analgesia, or inability to provide informed consent.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Cuidados de apoyo
- Asignación: No aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Experimental: Integrated Care with Spontaneous Pushing
Integrated Care with Spontaneous Pushing Group
|
Participants receive the integrated intrapartum supportive care program during the first stage of labor.
During the second stage, participants are encouraged to begin pushing in response to their spontaneous urge to push rather than routinely initiating pushing immediately after full cervical dilation.
The pushing strategy is implemented by the attending clinical care team according to the predefined group protocol.
|
|
Experimental: Integrated Care with Immediate Pushing
Integrated Care with Immediate Pushing Group
|
Integrated Care with Immediate Pushing Group: Participants receive an integrated intrapartum care package that includes continuous labor support and active birth positioning.
Once full cervical dilation is achieved, participants are instructed to begin pushing immediately, regardless of the presence or absence of an urge to push.
This directive approach to second-stage labor is guided by midwives or obstetric staff.
|
|
Comparador activo: Standard Routine Care
|
Participants receive routine intrapartum care according to institutional clinical practice.
Supportive measures and position changes may be provided according to maternal needs and clinical judgment, but participants do not receive the structured multicomponent integrated intrapartum supportive care program.
During the second stage of labor, pushing begins after full cervical dilation according to the attending clinical team's immediate pushing practice.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Duration of the first and second stages of labor
Periodo de tiempo: From the onset of active labor to the delivery of the fetus.
|
The duration of the first stage of labor is defined as the time interval from the onset of active labor-marked by regular, painful uterine contractions and cervical dilation of ≥6 cm-until full cervical dilation (10 cm).
The duration of the second stage of labor is defined as the time from full cervical dilation to the complete delivery of the fetus.
Labor durations will be recorded in minutes based on partograph entries and electronic medical records, with all timings verified by attending midwives or obstetric care providers to ensure accuracy.
|
From the onset of active labor to the delivery of the fetus.
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Caesarean Section Rate
Periodo de tiempo: During labor and delivery
|
The proportion of enrolled participants who undergo unplanned cesarean birth during labor or delivery.
Indications for cesarean birth will be extracted from the medical record.
|
During labor and delivery
|
|
Instrumental Vaginal Delivery Rate
Periodo de tiempo: During delivery
|
The proportion of participants who undergo instrumental vaginal delivery using forceps or vacuum extraction.
The use of instruments will be recorded based on delivery records, and indications will be documented when available.
|
During delivery
|
|
Augmentation Rate
Periodo de tiempo: During labor
|
The proportion of participants who receive augmentation of labor after spontaneous onset.
Administration details (timing, dosage, indication) will be obtained from medical records and partographs.
|
During labor
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Investigadores
- Investigador principal: Wan-Lin Pan, PhD, National Taipei University of Nursing and Health Sciences
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
10 de junio de 2025
Finalización primaria (Estimado)
31 de julio de 2026
Finalización del estudio (Estimado)
31 de julio de 2026
Fechas de registro del estudio
Enviado por primera vez
17 de junio de 2026
Primero enviado que cumplió con los criterios de control de calidad
17 de junio de 2026
Publicado por primera vez (Actual)
23 de junio de 2026
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
23 de junio de 2026
Última actualización enviada que cumplió con los criterios de control de calidad
17 de junio de 2026
Última verificación
1 de junio de 2026
Más información
Términos relacionados con este estudio
Palabras clave
Otros números de identificación del estudio
- 2024E02
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
NO
Descripción del plan IPD
This study does not plan to share individual participant data.
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .