Comparison of the Effects of Acupressure on Hugo point (LI 4) and Hyoscine on Length of Delivery Stages in Nulliparous Women: A Randomized Controlled Clinical Trial.

Abstract

Abstract: Introduction: Shortened duration of labor without creating major complications is ideal for mother and infant. Prolonged labor is accompanied by maternal and fetal consequences. Acupressure and medicines like hyoscine have both been used to avoid prolonged labor and accelerate the stages of labor. Considering its importance, the purpose of this study was to compare the effects of acupressure at the Hugo point (LI4) and hyoscine medicine on duration of labor stages and fetal-neonatal outcomes in nulliparous women. Methods: This controlled randomized clinical trial was carried out in 2017 on 162 qualified nulliparous women who referred to Ardabil Sabalan Hospital. Participants were divided into three groups of Hugo acupressure, hyoscine and control group by means of randomized blocks. There were 54 nulliparous women in each group. In the Hugo acupressure group, the pressure exerted on the Hugo point at 5 cm dilatation and in the hyoscine group, the hyoscine medicine was injected intramuscularly at 5 cm dilatation. Duration of labor stages and fetal-neonatal outcomes in all groups was measured and recorded in partograph and checklist by the researcher. Data were analyzed using one-way ANOVA, Kruskal-Wallis, Fisher’s exact and chi-square tests. Results: The mean (SD) duration of the active phase of labor in the Hugo, hyoscine and control group was 137/0 (15/1), 143/3 (17/2) and 187/7 (24/7) minutes respectively. Also, the mean (SD) duration of the second stage of labor in the Hugo, hyoscine and control group was 8.5 (39.5), 15.0 (52.4) and 8.7 (58.3) minutes respectively. The mean (SD) of labor length in the Hugo group (17.5) was 176.1, 19.63 (19.23), and 19.23 (19.6), and control (26.6), was 246.2 minutes. Based on one-way ANOVA, the length of delivery There was a significant statistical difference between the groups (p <0.001). The mean (SD) of labor length in the Hugo group (17.5) was 176.1, 19.63 (19.23), and 19.23 (19.6), and control (26.6), was 246.2 minutes. Based on one-way ANOVA, the length of delivery There was a significant statistical difference between the groups (p <0.001). There was a significant difference between the three groups in the duration of the active phase and the second stage of labor (p <0.001). There was no statistically significant difference between the three groups in the duration of the third stage of labor (P = 0.990). There was a significant difference between the three groups in terms of fetal bradycardia (P = 0.007) and first minute Apgar scores (p = 0.44). There was no significant difference between the three groups in terms of the need for resuscitation (P = 0.183), fetal tachycardia (P = 0.000), and fetal heart attack (P = 1.00). In the majority of women, Hugo (81.5%), Hyosine (81.5%) and Control (48.1%) of Oxytocin were not used in the three groups: Chi-square test showed a statistically significant difference between the groups There was (p <0.001). Approximately one hundred percent of women in all three groups had normal delivery, which was not statistically significant based on Fisher's exact test (p = 0.396). Discussion and Conclusion: The use of acupressure Hugo points to a greater reduction during the delivery stages than the use of hyoscine without causing side effects to the mother. It also improved the first minute Apgar score, reduced bradycardia, and decreased oxytocin usage. Therefore, the use of acupressure method is recommended to reduce the length of delivery and labor stages in normal delivery.