Regulated Expiratory Breathing Method During Childbirth

NCT ID: NCT04219631

Last Updated: 2021-03-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-01

Study Completion Date

2021-03-15

Brief Summary

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The factors affecting the rate of primary caesarean section births are complex, and identifying interventions to reduce this rate is challenging. Effective interventions targeting at women are mainly represented by Childbirth training workshops, psychoeducation and psychosocial couple-based programs. Considering non medical interventions targeting mothers, the pattern of breathing during labor that can help for vaginal delivery is a controversial topic. There are no data to support a policy of directed maternal breathing or pushing during vaginal delivery.

The abdomino-perineal concept was originally a postpartum rehabilitation technique. Currently, applications are increasing. During labor, expiration channeled by a flow regulator device offers support to women enduring the pain of uterine contractions. During the second stage, the expiratory regulated pushing allows a long, efficient and very intuitive push.

The use of this regulated expiratory breathing method was introduced in the study unit in January 2018. Despite a positive experience both reported by women and midwives, investigators have so far only subjective feedback without objective measurable clinical impact.

As a result, investigators are conducting this scientific study whose main objective is:

\- To Evaluate the impact of a regulated expiratory breathing method on childbirth process .

Detailed Description

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Rates of cesarean delivery continue to rise worldwide, with recent (2016) reported rates of 24.5% in Western Europe, 32% in North America, and 41% in South America.

Primary cesarean deliveries account for more than half of all cesarean deliveries, and the most common indication for repeat cesarean delivery is previous cesarean delivery.

Consequently, the reduction in primary cesarean delivery rate represents a meaningful objective.

The factors affecting the rate of primary caesarean section births are complex, and identifying interventions to reduce this rate is challenging. Effective interventions targeting at women are mainly represented by Childbirth training workshops, psychoeducation and psychosocial couple-based programs. Considering non medical interventions targeting mothers, the pattern of breathing during labor that can help for vaginal delivery is a controversial topic. There are no data to support a policy of directed maternal breathing or pushing during vaginal delivery.

The abdomino-perineal concept was originally a postpartum rehabilitation technique. Currently, applications are increasing. Currently, applications are increasing. During labor, expiration channeled by a flow regulator device offers support to women enduring the pain of uterine contractions. During the second stage, the expiratory regulated pushing allows a long, efficient and very intuitive push.

The use of this regulated expiratory breathing method was introduced in the study unit in January 2018. Despite a positive experience both reported by women and midwives, we investigators have so far only subjective feedback without objective measurable clinical impact.

As a result, investigators are conducting this scientific study whose main objective is:

\- To Evaluate the impact of a regulated expiratory breathing method on childbirth process .

Conditions

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Childbirth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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WINNER- FLOW-URO-MG GROUP

After admission to the delivery room, all women assigned to WF + group will have an interview with one of the midwifes responsible for the study. The latter will explain the use of the WINNER FLOW®-URO MG® device which is the expiration mouthpiece used during breathing exercises to ensure a constant ventilatory flowrate. Then, WF+ patients will use the expiratory mouthpiece device during all their childbirth process.

Group Type EXPERIMENTAL

expiration mouthpiece used during breathing exercises to ensure a constant ventilatory flowrate.

Intervention Type DEVICE

women enrolled in WINNER-FLOW-URO-MG group will freely use the expiratory mouthpiece device during all their childbirth process.

NO WINNER-FLOW-URO-MG GROUP

Women enrolled in WF- group will be managed classically during their child birth process regardless to the study participation.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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expiration mouthpiece used during breathing exercises to ensure a constant ventilatory flowrate.

women enrolled in WINNER-FLOW-URO-MG group will freely use the expiratory mouthpiece device during all their childbirth process.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Primiparae
* Singleton pregnancy
* Gestational age ≥ 37 SA
* Fetus in cephalic presentation
* Fetus with a normal weight for a the gestational age
* Spontaneous onset of labor
* Early stage of labor (with cervical dilatation under 3 cm)
* No previous Childbirth training workshops

Exclusion Criteria

* Parity of at least 2
* Multiple pregnancy
* Intra uterine fetal demise
* Previous uterine scar
* Fetus in Breach presentation
* Non Vertex cephalic presentation
* Narrowed pelvic bone diameters
* A contraindication to vaginal delivery (placenta previa , fibroma previa, …)
* Previous participation to childbirth training workshops
* Women in an advanced stage of labor with a cervical dilation upon admission over 3 cm
* Women requiring epidural anesthesia
* Refusal of participation
Minimum Eligible Age

18 Years

Maximum Eligible Age

46 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University Tunis El Manar

OTHER

Sponsor Role lead

Responsible Party

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Kaouther Dimassi

associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Mongi Slim University Hospital

Tunis, Sidi Daoued La Marsa, Tunisia

Site Status

Countries

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Tunisia

References

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Dimassi K, Halouani A, Ben Zina F, Khemessi N, Triki A. Regulated Expiratory Methods During Childbirth Process: A Randomized Controlled Trial. J Obstet Gynaecol Can. 2024 Mar;46(3):102265. doi: 10.1016/j.jogc.2023.102265. Epub 2023 Nov 7.

Reference Type DERIVED
PMID: 37940044 (View on PubMed)

Other Identifiers

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Winner flow-URO- MG Mongi Slim

Identifier Type: -

Identifier Source: org_study_id

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