Effect of Open Glottis versus closed Glottis (Valsalva) in Second Stage of Labor on Maternal and Neonatal Outcomes | ||||
| Egyptian Journal of Health Care | ||||
| Article 85, Volume 13, Issue 1, March 2022, Page 1252-1266 PDF (268.68 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhc.2022.226064 | ||||
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| Authors | ||||
| Safaa Soliman Ahmed Mohamed1; Abeer Nasr Eldeen Elsadek2; Eman M Khalil3; Hanaa kamal Helmy1 | ||||
| 1Assistant Professor of Maternal and Neonatal Health Nursing Beni-sueif University, Egypt | ||||
| 2Lecturer of Maternal and Neonatal Health Nursing Beni-sueif University, Egypt | ||||
| 3Lecturer of Obstetrics &Gynecology, Faculty of Medicine Beni-sueif University, Egypt | ||||
| Abstract | ||||
| Background: Maternal pushing during the second stage of labor is crucial and important contributor to the involuntary expulsive force developed by uterine contraction results to influence on the mother and fetus. Aim: the study was conducted to compare between the effect of open glottis versus closed glottis (valsalva) in second stage of labor on maternal and neonatal outcomes. Methods: Setting: Delivery Unit of Beni-suef University Hospitals. Design: A quasi-experimental comparative study. Subjects: A purposive sample of a total of 150 primiparous women; 75 in the Open Glottis group& 75 in the closed glottis (Valsalva) group. Tools: four tools were used; structured interviewing questionnaire , Apgar score, Visual analog scale, and women satisfaction questionnaire. Results: The duration of the 2nd stage of labor was shorter (5-10 min) in a open glottis (spontaneous) (54.0%) group compared to the closed glottis pushing group (2.0%). Oxygen wasn't used at all in open glottis pushing group compared to 74.0% of closed glottis pushing group. postpartum hemorrhage was too little in open glottis pushing group (96.0%) compared to 36.0% of the closed glottis pushing group. Also, all women in the open glottis pushing group experienced mild perineal pain compared to 32.0% in the directed pushing group (p < 0.001). The individual items of the VAS were significantly higher in the closed glottis pushing group than those in the open glottis pushing group. According to Apgar's score, there was a significant difference between the two groups during both the first and fifth minutes of birth. In the closed glottis pushing group, a higher proportion of babies are admitted to ICU than those in the open glottis pushing group (18.0 percent versus 10.0 percent). Conclusion; open glottis pushing during the 2nd stage of labor enhanced neonatal and maternal outcomes; whilst closed glottis pushing was associated with an increased duration of the 2nd stage of labor, risk of adverse neonatal outcomes and the postpartum hemorrhage was too little in open glottis pushing group. Recommendations: It may be recommended that open glottis pushing during the second stage of childbirth be included in the procedure for maternal hospitals | ||||
| Keywords | ||||
| Maternal; neonatal; outcomes; open glottis; closed glottis (valsalva); pushing; second stage of labor | ||||
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