Integrated Intrapartum Supportive Care and Pushing Strategies in Women Receiving Low-Dose Epidural Analgesia
17. juni 2026 oppdatert av: 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.
Studieoversikt
Status
Rekruttering
Detaljert beskrivelse
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.
Studietype
Intervensjonell
Registrering (Antatt)
159
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiekontakt
- Navn: Wan-Lin Pan, PhD
- Telefonnummer: +886-2-2822-7101 ext. 7101
- E-post: wanlimp@gmail.com
Studiesteder
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-
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Taipei, Taiwan, 10556
- Rekruttering
- Taiwan Adventist Hospital
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Ta kontakt med:
- Wan-Lin Pan
- Telefonnummer: 0933710737
- E-post: wanlimp@gmail.com
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Nei
Beskrivelse
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.
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Støttende omsorg
- Tildeling: Ikke-randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: Integrated Care with Spontaneous Pushing
Integrated Care with Spontaneous Pushing Group
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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.
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Eksperimentell: Integrated Care with Immediate Pushing
Integrated Care with Immediate Pushing Group
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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.
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Aktiv komparator: Standard Routine Care
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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.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Duration of the first and second stages of labor
Tidsramme: From the onset of active labor to the delivery of the fetus.
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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.
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From the onset of active labor to the delivery of the fetus.
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Caesarean Section Rate
Tidsramme: During labor and delivery
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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.
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During labor and delivery
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Instrumental Vaginal Delivery Rate
Tidsramme: During delivery
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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.
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During delivery
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Augmentation Rate
Tidsramme: During labor
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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.
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During labor
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Etterforskere
- Hovedetterforsker: Wan-Lin Pan, PhD, National Taipei University of Nursing and Health Sciences
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
10. juni 2025
Primær fullføring (Antatt)
31. juli 2026
Studiet fullført (Antatt)
31. juli 2026
Datoer for studieregistrering
Først innsendt
17. juni 2026
Først innsendt som oppfylte QC-kriteriene
17. juni 2026
Først lagt ut (Faktiske)
23. juni 2026
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
23. juni 2026
Siste oppdatering sendt inn som oppfylte QC-kriteriene
17. juni 2026
Sist bekreftet
1. juni 2026
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Andre studie-ID-numre
- 2024E02
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
NEI
IPD-planbeskrivelse
This study does not plan to share individual participant data.
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Nei
Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .