title: Duration of the second stage of labor while wearing a dental support device: a pilot study.
abstract: OBJECTIVE
  Developing a method of maximizing maternal expulsive effort should be of great value in reducing the number of cesarean sections or instrumental deliveries. Various investigations have shown that use of a dental support device (DSD) increases the isometric strength of different muscle groups. The aim of our study was to investigate the role of a DSD in second stage of pushing.
  
  
  METHODS
  Nulliparous women with an uncomplicated singleton pregnancy course were randomly assigned either to a DSD group or to a non-device group. Duration of the second stage of labor was evaluated. Rates of cesarean section or instrumental delivery indicated for failure to descend in the second stage of labor were also evaluated. Satisfaction scores for the DSD group were evaluated (range 1-5).
  
  
  RESULTS
  Sixty-four subjects were enrolled in the study. Cesarean section and instrumental delivery were performed for 12 (18.8%) and 5 (7.8%) patients, respectively. There was no difference in obstetrical and neonatal demographics between the two groups. Among 64 enrolled patients, 38 (59.3%) were evaluated for the second stage of labor (n = 19 for each group). Duration of the second stage of labor in the DSD group was significantly shorter than in the non-device group: (median 19 min (interquartile interval, IQI, 9) vs 31 min (IQI, 23)), P < 0.001. One patient in the non-device group required a vacuum extraction for failure to descend. The mode of satisfaction score for the DSD group was 5 (59.3%).
  
  
  CONCLUSIONS
  Wearing a dental support device may shorten the second stage of labor, and may decrease the number of failures to descend requiring operative intervention.
  
  
  BACKGROUND
  NCT00629369.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA. koji.matsuo@gmail.com
authors.forename: Koji
authors.initials: K
authors.lastname: Matsuo
authors.forename: Janna V
authors.initials: JV
authors.lastname: Mudd
authors.forename: Jerome N
authors.initials: JN
authors.lastname: Kopelman
authors.forename: Robert O
authors.initials: RO
authors.lastname: Atlas
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007748:Labor Stage, Second; D053580:Muscle Strength; D009967:Orthodontic Appliances; D017060:Patient Satisfaction; D010865:Pilot Projects; D011187:Posture; D011247:Pregnancy; D013997:Time Factors; D014636:Valsalva Maneuver