title: A comparison of maternal and neonatal outcomes between water immersion during labor and conventional labor and delivery.
abstract: BACKGROUND
  Water immersion during the first stage of labor can reduce the length of the first stage and epidural/spinal analgesia use; however, there is limited information regarding other outcomes. Our purpose was to compare maternal and neonatal outcomes of women who underwent water immersion during the first stage of labor with those who underwent conventional labor and delivery.
  
  
  METHODS
  Healthy primipara with singleton pregnancies and cephalic presentation were included in the study. Patients were allowed to choose water immersion during labor or conventional labor and delivery. For water immersion, the water temperature was maintained at 35-38°C and subjects left the tub on complete cervical dilatation. A visual analogue scale (VAS) was used to assess pain during labor. Other outcome measures included duration of labor, type of delivery, blood loss, pelvic floor dysfunction and symptoms of stress urinary incontinence (SUI) at 42 days after delivery, infant Apgar scores, and need for transfer of the infant to the neonatal intensive care unit.
  
  
  RESULTS
  Thirty eight subjects (mean age, 28.66 ± 3.08 y) received water immersion and 70 (mean age, 27.89 ± 2.99 y) underwent conventional labor and delivery. There were no differences in maternal height, weight, age, gestational age, gravidity, and newborn weight between the groups (all, p>0.05). VAS pain scores were significantly greater in the conventional labor group at 30 min and 60 min after a cervical dilatation of 3 cm (30 min: 10 [9, 10] vs. 6 [5, 8]; 60 min: 10 [10, 10] vs. 7 [6, 8], respectively, both, p<0.001). The duration of labor and postpartum bleeding were similar between the groups (all, p>0.05). The cesarean section rate was higher in the conventional labor group (32.9% vs. 13.2%, p=0.026). The 1-minute and 5-minute Apgar scores were similar between the groups. Maternal and neonatal culture results were similar between the groups. SUI symptoms at 42 days after delivery was significantly higher in the conventional labor group (25.5% vs. 6.1%, respectively, p=0.035).
  
  
  CONCLUSIONS
  Water immersion can reduce labor pain, and is associated with a lower rate of cesarean delivery and SUI symptoms at 42 days.
authors.forename: Yinglin
authors.initials: Y
authors.lastname: Liu
authors.forename: Yukun
authors.initials: Y
authors.lastname: Liu
authors.forename: Xiuzhi
authors.initials: X
authors.lastname: Huang
authors.forename: Chuying
authors.initials: C
authors.lastname: Du
authors.forename: Jing
authors.initials: J
authors.lastname: Peng
authors.forename: Peixian
authors.initials: P
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No 107, Yanjiang West Road, Guangzhou, Guangdong 510120, China. zjp2570@126.com.
authors.forename: Jianping
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001034:Apgar Score; D001424:Bacterial Infections / Q000382:microbiology; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007101:Immersion / Q000009:adverse effects; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D048949:Labor Pain; D007747:Labor Stage, First; D009321:Natural Childbirth / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D059952:Pelvic Floor Disorders / Q000209:etiology; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000209:etiology; D014867:Water; D055815:Young Adult
chemical_list: D014867:Water