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“ LABORING DOWN” Passive Descent Delayed Pushing Small Randomised Controlled Trials with Different outcome measures & variable amounts of “time for delay before pushing” have created fuel for passionate positions
ACOG PRACTICE BULLETIN 2003 No 49 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Laboring Down” WHAT IS THE EVIDENCE  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multicenter, randomized, controlled trial of delayed pushing for  Nulliparous  women in the second stage of labor with  Continuous Epidural Analgesia .  Am J Obstet Gynecol 2000;182:1165   (n = 1862)   (1994-1996) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multicenter, randomized, controlled trial of delayed pushing for  Nulliparous  women in the second stage of labor with  Continuous Epidural Analgesia .  Am J Obstet Gynecol 2000;182:1165   (n = 1862)   (1994-1996) MEDIAN DELAY   ~  2 HOURS  (  40 % > 2 HRS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
A Meta-Analysis  of passive descent versus immediate pushing in  Nulliparous women  with  Epidural analgesia  in the second stage of labor. J Obstet Gynecol Neonatal Nurs. 2008 Jan-Feb;37(1):4-12. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Candidates for Delayed Pushing Maximum delay 90  minutes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Labor Down Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Labor down

  • 1. “ LABORING DOWN” Passive Descent Delayed Pushing Small Randomised Controlled Trials with Different outcome measures & variable amounts of “time for delay before pushing” have created fuel for passionate positions
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.