Labor Pain Clinical Trial
Official title:
Therapeutic Rest to Delay Admission in Early Labor: A Prospective Study on Morphine Sleep
This will be a prospective study on labor characteristics, and obstetric and neonatal outcomes in women who accept and women who decline morphine as a form of pain management in labor. The study will also investigate patient satisfaction with this form of analgesia. The participants will be those who accept morphine and promethazine and those who decline morphine and promethazine for pain control.
Objective: Therapeutic rest in labor involves administration of parenteral analgesics in
early or prodromal labor to relieve the patient's discomfort and allow for progression of
labor while the patient rests. No prospective studies exist which examine the safety and
clinical utility of therapeutic rest in early labor, and no published studies examine the
potential benefits of therapeutic rest from the perspective of either patient satisfaction or
cost-effectiveness. The investigators aim to determine whether therapeutic rest using
morphine and promethazine is associated with variations in labor characteristics, or
obstetric or neonatal outcomes as well as patient satisfaction with this form of pain
management.
Methods: This will be a prospective cohort study. Women who are eligible for therapeutic rest
(reactive non-stress test, normal amniotic fluid, in prodromal or early labor as defined by
obstetric provider, and plan to discharge home after evaluation) will be recruited for the
study. Participants will receive routine obstetric care by providers who are unaware of
patient enrollment. A research assistant will then approach all participants in the
postpartum period, prior to discharge from the hospital or with a phone call if permitted by
the patient, to complete a questionnaire including patient satisfaction items. Chart review
will be performed to determine differences in hospital stay and common obstetric and neonatal
outcomes to compare these data among women who do and do not choose to receive therapeutic
rest. These results will provide insight into a common clinical practice, helping to not only
guide management at institutions where therapeutic rest is commonly utilized but also
potentially encourage its initiation at hospitals were therapeutic rest is not available.
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