اعظم جوکار

Sedatives constitute an important part of modern obstetric care. One of the under-investigation methods is the effect of acupressure on reduction of the duration of labor stages. This study was performed aiming at comparison of the effects of one-step acupressure of spleen point 6 (SP-6) and gall bladder 21 (GB-21) on the duration and type of delivery and Apgar of newborne in nulliparous women.

This clinical trial study was performed on 150 nulliparous women. Women were randomly assigned to three groups, including gallbladder 21 acupressure, spleen point 6 acupressure, and control. In first two groups, pressure was performed at 3-4cm cervical dilatation for 20 minutes. In the control group, contact with no pressure was done on the acupressure points and with the same condition of the intervention group. The collected data was analyzed using paired t-test, independent t-test, and one-way variance analysis.

In this study, the duration of the active stage of labor in the intervention group was less than control group (p<0.05), but no significant difference was observed in the two intervention groups (p>0.05). Also, duration of the second stage of labor in the control group was more than two experimental groups, but the difference was not significant (p>0.05). The three groups, had no significant difference in the fifth minute Apgar score (p>0.05). The number of cesarean sections in the intervention groups were more than control group (p<0.05).

According to the results of this study, the acupressure in SP-6 and GB-21 points, in the one-step intervention was equally effective in reducing the duration of active stage of labor.

Many women avoid invasive and medication methods to reduce labor pain. One of the concerns of mother and her family is labor pain and method of relieving it which vastly affect the quality of care during labor, patient's satisfaction, and finally delivery itself. The aim of the survey is to compare the effect of Two-staged acupressure at GB-21 and SP-6 points on the labor pain of active phase in nulliparous women who were admitted at selected hospitals of Shiraz university of medical sciences.

This clinical trial study was implemented on 150 pregnant women who referred to the labor room of maternity ward of Hafez and Shooshtari hospitals of Shiraz city (2010). In this study effects of acupressure at two points of acupoint (SP-6) and gallbladder 21 (GB-21) in two stages of intervention dilatation (3-4, 7-8 cm) on labor pain were compared with each other and with control group. Sample participants were divided into three groups of acupressure at GB-21 point, acupressure at SP-6 point, and control. Pain measurement was done immediately before, 30 and 60 minutes after intervention using the numerical-visual chart (VAS) in all three groups. In the control group, contact without pressure on acupressure points was applied with the same condition of intervention group. Data collection tools included information form and numeric pain rating scale. Collected data were analyzed by using SPSS statistical software version 16, Paired t-tests, independent t-test, ANOVA, and ANOVA of repeated measures. P value less than 0.05 was considered statistically significant.

According to ANOVA of repeated measures, statistically significant difference was observed in pain intensity immediately before, and 30 and 60 minutes after the intervention in three groups of 3-4 and 7-8 cm cervical dilatation (p<0.001). Based on LSD multiple comparison, there was significant difference between pain labor intensity in two-staged groups (p<0.001). Labor pain intensity showed no significant difference in two intervention groups (p=0.93).

The use of acupressure in two stages of dilatation (3-4 and 7-8 cm) is non-invasive, easy and effective in reducing pain in labor and can be used easily used in delivery room. This method is effective in promoting satisfaction and positive experience of labor, and reducing elective cesarean delivery. Since there is no difference in reduction of pain intensity in two points, using any of the points can be effective.