The purpose of this thesis was to develop best practice recommendations to care for women in the second stage of labor. Evidence suggests that care of women during the second stage of labor using upright positioning, delayed pushing, application of warm compresses to the perineum, and perineal massage can improve maternal and neonatal outcomes (Aasheim et al., 2011; Brancato et al., 2008; Chang...

introduction:   although there no agreement about best way for relieving  pain in delivery, finding an appropriate method with the lowest pain and drug dose and side effect shoud be considered. the aim of this study is to compare the analgesic efficacy and side effects of remifentanil and meperidine as two methods of pain relieving in obstetrics during an uncomplicated labor.  materials and met...

OBJECTIVE To evaluate whether maintaining a motor-sparing epidural analgesia infusion affects the duration of the second stage of labor in nulliparous parturients compared with a placebo control. METHODS We conducted a double-blind, randomized, placebo-controlled trial involving nulliparous women with term cephalic singleton pregnancies who requested epidural analgesia. All women received epi...

Scientific evidence supports spontaneous physiologic approaches to second-stage labor care; however, most women in US hospitals continue to receive direction from nurses and birth attendants to use prolonged Valsalva bearing-down efforts as soon as the cervix is completely dilated. Delaying maternal bearing-down efforts during second-stage labor until a woman feels an urge to push (laboring dow...

 Introduction: The aim of this study is to compare the efficacy of epidural versus entonox methods for labor analgesia in nulliparous women.  Methods: This randomized controlled trial was performed on 84 nulliparous women with - pregnancy admitted to Imam Reza Hospital in 10 May 2010- 10 May 2011.  They were randomly divided into two groups 42 women inhaled entonox in active phase at the ...