Pregnancy Clinical Trial
Official title:
Duration of Second Stage of Labor Wearing a Dental Occlusion Device: a Randomized Controlled Trial
Developing a method to maximize maternal expulsive effort should be of great value in reducing the number of cesarean section or instrumental deliveries. Various investigations have shown that use of an occlusal support device (OSD) increases the isometric strength of different muscle groups. The aim of our study was to investigate the role of an OSD in second stage pushing.
The increased use of epidural anesthesia during labor has lead to an increased incidence of
prolonged second stage as an indication for cesarean section or instrumental delivery. The
use of oxytocin has proven to be an effective method of augmentation of labor in such
prolonged labor cases. However, despite oxytocin augmentation, there has been an increase in
the number of cases that require cesarean section or instrumental delivery to effect
delivery.
McRobert's maneuver, which is often used in to relieve shoulder dystocia, has recently been
shown to increase intrauterine pressure approximately two-fold. However; it is an arduous
position for the pregnant woman to maintain over a long period of time. Developing
alternative methods to maximize expulsive forces, both uterine contractions and maternal
expulsive effort, may be of great value in reducing the number of cesarean sections or
instrumental deliveries.
Various researchers have investigated the effect of an occlusal support device (OSD) on the
isometric strength of different muscle groups, e.g., neck, back, and extremities. The
natural condition of dental occlusion, also known as the index of physical performance, has
an affect on both muscle strength and body balance. When occlusal support is given to
edentulous individuals they show improved physical exercise ability after the
re-establishment of mandibular support. Patients whose dentition is in proper occlusion
demonstrate greater endurance of isometric muscle strength than those who are in
malocclusion. We hypothesize that optimization of dental occlusion by an OSD may improve
muscle strength, leading to increased intrauterine pressure during the second stage in
labor.
The aim of our study is to investigate whether the use of the OSD results in a shortened
duration of the second stage of labor.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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