Comparison of the effects of maternal supportive care and Acupressure (at BL32 Acupoint) during labor on the mother’s anxiety level and Arterial oxygen pressure of the umbilical cord of infants (PO2)
Subject Areas : Other related topicsZahra Masoudi 1 * , Marziah AkbarZadeh 2 , Najaf Zare 3
1 -
2 -
3 -
Keywords: Acupressure, Anxiety, Doula, po2,
Abstract :
Background: The amount of umbilical cord blood gas reflects the fetus’ metabolic status and is one of the main diagnostic criteria of birth asphyxia. The question is whether anxiety caused by labor pain of the mother affects asphyxia birth and umbilical cord blood gases? Comparison of the effects of maternal supportive care and acupressure (BL32 acupoint) during labor on the mother’s anxiety level and Arterial oxygen pressure of the umbilical cord of infants (PO2). Materials and Methods: This clinical trial was performed on 150 pregnant women who were randomly assigned to two interventions and a control group in the delivery ward of the selected educational center of Shiraz University of Medical Sciences (Shoushtari hospital). Mothers’ anxiety scores before (beginning of the active stage of labor) and after the intervention (the end of the first stage of labor) were measured using Spielberger’s questionnaire. then infants’ cord blood samples for arterial blood gas and hematologic analyses sent to the hospital’s laboratory. After all, the data with SPSS version16 and using Pearson’s correlation coefficient, one-way ANOVA, were analyzed. Results: The mean of anxiety score in the control group was 21.1% and in the support group and the acupressure group, decreased by 37.5% and 34.8% respectively (p<0.001). The mean of PO2 was also reported in maternal supportive, acupressure, and control groups, 40.4±8.8, 27.4±2.8, and 18.1±3.7, respectively. Additionally, a significant correlation was found between mothers’ anxiety scores after the intervention and the mean of PO2 (p=0.014). Conclusion: The supportive care and acupressure at BL32 acupoint reduced mothers’ anxiety and, consequently, improved fetal oxygenation. SO, the Support group was better than the acupressure group, but they were not statistically significant.
1. Gau M-L, Chang C-Y, Tian S-H, Lin K-C. Effects of birth ball exercise on pain and self-efficacy during childbirth: A randomised controlled trial in Taiwan. Midwifery. 2011;27(6):e293-e300.
2. Chuntharapat S, Petpichetchian W, Hatthakit U. Yoga during pregnancy: Effects on maternal comfort, labor pain and birth outcomes. Complementary Therapies in Clinical Practice. 2008;14(2):105-15.
3. Urech C, Fink NS, Hoesli I, Wilhelm FH, Bitzer J, Alder J. Effects of relaxation on psychobiological wellbeing during pregnancy: A randomized controlled trial. Psychoneuroendocrinology. 2010;35(9):1348-55.
4. Reynolds F. The effects of maternal labour analgesia on the fetus. Best Pract Res Clin Obstet Gynaecol. 2010;24(3):289-302.
5. Alehagen S, Wijma K, Lundberg U, Melin B, Wijma B. Catecholamine and cortisol reaction to childbirth. International Journal of Behavioral Medicine. 2001;8(1):50-65.
6. Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? Where? Why? Lancet. 2005;365(9462):891-900.
7. Martin RJ, Fanaroff AA, Walsh MC. Neonatal perinatal medicine. 5(2)2006. p. 1291.
8. Nelson KB, Dambrosia JM. Uncertain value of electronic fetal monitoring in predicting cerebral palsy. N Eng J Med. 1996;334:613-8.
9. Su C-F, Tsai H-J, Huang C-C, Luo K-H, Lin L-Y. Fetal Acidosis from Obstetric Interventions During the First Vaginal Delivery. Taiwanese Journal of Obstetrics and Gynecology. 2008;47(4):397-401.
Dudenhausen JW, Luhr C, Dimer JS. Umbilical artery blood gases in healthy term newborn infants. Int J Gynaecol Obstet. 1997;57(3):251-8.
10. Nelson KB, Ellenberg JH. Apgar scores as predictors of chronic neurologic disability. Pediatrics. 1981;68(1):36-44.
11. Cheng Y, Gidday JM, Yan Q, Shah AR, Holtzman DM. Marked age-dependent neuroprotection by brain-derived neurotrophic factor against neonatal hypoxic-ischemic brain injury. Ann Neurol. 1997;41(4):521-9.
12. Gluckman PD, Wyatt JS, Azzopardi D, Ballard R, Edwards AD, Ferriero DM, et al. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet. 2005;365(9460):663-70.
13. Fink NS, Urech C, Isabel F, Meyer A, Hoesli I, Bitzer J, et al. Fetal response to abbreviated relaxation techniques. A randomized controlled study. Early Human Development. 2011;87(2):121-7.
14. Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol. 2008;51:333-48.
15. Lundgren I. Swedish women's experiences of doula support during childbirth. Midwifery. 2010;26(2):173-80.
16. Gilliland AL. After praise and encouragement: Emotional support strategies used by birth doulas in the USA and Canada. Midwifery. 2011;27(4):525-31.
17. Simkin P, Bolding A. Update on Nonpharmacologic Approaches to Relieve Labor Pain and Prevent Suffering. Midwifery & Women’s Health. 2004;49(6):489-504.
18. Melzack R, Belanger E, Lacroix R. Labor pain: effect of maternal position on front and back pain. J Pain Symptom Manage. 1991;6(8):476-80.
19. Yip YB, Tse SHM. The effectiveness of relaxation acupoint stimulation and acupressure with aromatic lavender essential oil for non-specific low back pain in Hong Kong: a randomised controlled trial. Complementary Therapies in Medicine. 2004;12(1):28-37.
20. Chung UL, Hung LC, Kuo SC, Huang CL. Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor. J Nurs Res. 2003;11(4):251-60.
21. Chao A-S, Chao A, Wang T-H, Chang Y-C, Peng H-H, Chang S-D, et al. Pain relief by applying transcutaneous electrical nerve stimulation (TENS) on acupuncture points during the first stage of labor: A randomized double-blind placebo-controlled trial. PAIN. 2007;127(3):214-20.
22. Agarwal A, Ranjan R, Dhiraaj S, Lakra A, Kumar M, Singh U. Acupressure for prevention of pre-operative anxiety: a prospective, randomised, placebo controlled study. Anaesthesia. 2005;60(10):978-81.
23. Hadianfard M. Acupoints In illustrated tables. In: Shokrpour N, editor. Shiraz, Iran: Mangan; 2011. p. 132.
24. Hofmeyr GJ, Nikodem VC, Wolman W, etal. Companionship to Modify the Clinical Birth Enviorment:Effects on progress and perceptions of Labour and Breast Feeding. Br J Obstet Gynecol. 1991;98(1):756-64.
25. Scott KD, Klaus PH, Klaus MH. The obstetrical and postpartum benefits of continuous support during childbirth. J Womens Health Gend Based Med. 1999;8(10):1257-64.
26. Teixeira JM, Fisk NM, Glover V. Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study. BMJ. 1999 Jan 16;318(7177):153-7.
27. Albers L. The evidence for physiologic managment of the active phase of the first stage of labor. J Midwifery Womens Health. 2007;52(3):207-15.
28. Rosen P. Supporting women in labor:analysis of different types of care givers. J Midwifery Womens Health. 2004;49(1):24-31.
29. Pilkington K, Kirkwood G, Rampes H, Cummings M, Richardson J. Acupuncture for anxiety and anxiety disorders--a systematic literature review. Acupunct Med. 2007;25(1-2):1-10.
30. Edelman M, Ficorelli C. A measure of success: nursing students and test anxiety. J Nurses Staff Dev. 2005;21(2):55-9; quiz 60-1.
31. Davim RM, Torres Gde V, Melo ES. Non-pharmacological strategies on pain relief during labor: pre-testing of an instrument. Rev Lat Am Enfermagem. 2007;15(6):1150-6.
32. Barker R, Kober A, Hoerauf K, Latzke D, Adel S, Kain ZN, et al. Out-of-hospital auricular acupressure in elder patients with hip fracture: a randomized double-blinded trial. Acad Emerg Med. 2006;13(1):19-23.
33. Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol. 2008;51(2):333-48.
34. Akiyoshi J. [Neuropharmacological and genetic study of panic disorder]. Nihon Shinkei Seishin Yakurigaku Zasshi. 1999;19(3):93-9.
35. Ninan PT. The functional anatomy, neurochemistry, and pharmacology of anxiety. J Clin Psychiatry. 1999;60 Suppl 22:12-7.
36. Kotani N, Hashimoto H, Sato Y, Sessler DI, Yoshioka H, Kitayama M, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anesthesiology. 2001;95(2):349-56.
37. Enkin C. A guide of effective care pregnancy & childbirth.: Oxford university press; 1996.