A Meta-Analysis of Passive Descent Versus Immediate Pushing in Nulliparous Women With Epidural Analgesia in the Second Stage of Labor Robyn M. Brancato,

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Presentation transcript:

A Meta-Analysis of Passive Descent Versus Immediate Pushing in Nulliparous Women With Epidural Analgesia in the Second Stage of Labor Robyn M. Brancato, MA, BS, RN, Sara Church, BS, RN, Patricia W. Stone, PhD, MPH, MS Journal of Obstetric, Gynecologic & Neonatal Nursing Volume 37, Issue 1, Pages 4-12 (January 2008) DOI: 10.1111/j.1552-6909.2007.00205.x Copyright © 2008 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 1 Spontaneous vaginal births with delayed pushing versus immediate pushing. Note.RR = relative risk; CI = confidence interval. Size of the square indicates weight of study, as determined using Mantel-Haenszel weighting method. Journal of Obstetric, Gynecologic & Neonatal Nursing 2008 37, 4-12DOI: (10.1111/j.1552-6909.2007.00205.x) Copyright © 2008 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 2 Risk of instrument-assisted delivery with delayed pushing versus immediate pushing. Note.RR = relative risk; CI = confidence interval. Size of the square indicates weight of study, as determined using Mantel-Haenszel weighting method. Journal of Obstetric, Gynecologic & Neonatal Nursing 2008 37, 4-12DOI: (10.1111/j.1552-6909.2007.00205.x) Copyright © 2008 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 3 Time spent pushing during second-stage labor in delayed versus immediate pushing. Note.CI = confidence interval. Size of the square indicates weight of study, as determined using Mantel-Haenszel weighting method. Journal of Obstetric, Gynecologic & Neonatal Nursing 2008 37, 4-12DOI: (10.1111/j.1552-6909.2007.00205.x) Copyright © 2008 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 4 Risk of cesarean birth with delayed pushing versus immediate pushing. Note.RR = relative risk; CI = confidence interval. Size of the square indicates weight of study, as determined using Mantel-Haenszel weighting method. Journal of Obstetric, Gynecologic & Neonatal Nursing 2008 37, 4-12DOI: (10.1111/j.1552-6909.2007.00205.x) Copyright © 2008 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 5 Risk of laceration with delayed pushing versus immediate pushing. Note.RR = relative risk; CI = confidence interval. Size of the square indicates weight of study, as determined using Mantel-Haenszel weighting method. Journal of Obstetric, Gynecologic & Neonatal Nursing 2008 37, 4-12DOI: (10.1111/j.1552-6909.2007.00205.x) Copyright © 2008 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions

Figure 6 Risk of episiotomy with delayed pushing versus immediate pushing. Note.RR = relative risk; CI = confidence interval. Size of the square indicates weight of study, as determined using Mantel-Haenszel weighting method. Journal of Obstetric, Gynecologic & Neonatal Nursing 2008 37, 4-12DOI: (10.1111/j.1552-6909.2007.00205.x) Copyright © 2008 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses Terms and Conditions