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Created on : 31 Mar 2005
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

The rational management of labor. Am Fam Physician. 1993 May 1;47(6):1471-81.

Author(s) :

Smith MA, Ruffin MT 4th, Green LA.

Year of publication :

1993

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

Abstract (English)  :

Some practices and procedures that are common during the management of childbirth lack proof of efficacy, and some have adverse effects. The practice of withholding food and liquids and using intravenous fluids during labor may pose risks such as fluid overload, and maternal and fetal hyperglycemia. Enemas should be reserved for women with painful constipation. Evidence does not support the value of shaving the perineal area. Nonpharmacologic measures to control pain during labor are safe and moderately effective. Pharmacologic methods of analgesia and anesthesia provide good pain relief but pose significant risks. Continuous electronic fetal monitoring should be considered a diagnostic procedure, not a screening procedure. Amniotomy may shorten labor but can result in abnormally high uterine forces, infection, umbilical cord prolapse and fetal laceration. Position changes and alternative birth positions promote greater comfort and efficiency during labor. Finally, episiotomy has not been shown to reduce severe lacerations or prevent pelvic relaxation, and use of this procedure should be limited.

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

Une revue des mauvaise pratiques. Les changements de position et les positions non-conventionnelles augmentent le confort et l’efficacité du travail. La pratique de l’épisiotomie n’a pas réduit l’incidence des déchirures profondes.

Argument (English):

Position changes and alternative birth positions promote greater comfort and efficiency during labor.

Argumento (português):

Argumento (español):

Keywords :

➡ evidence-based medicine/midwifery ; position during labor ; physiology ; duration of labour ; ethics ; deontology ; informed consent ; episiotomy ; active management of labor ; pain medication ; IV ; epidural ; rupture of membranes ; amniotomy ; pain ; monitoring

Author of this record :

Cécile Loup — 31 Mar 2005
➡ latest update : Bernard Bel — 02 Dec 2007