Clinical Research Directory

Different Medications to Induce Labor

This is a randomized controlled trial examining whether the use of misoprostol or pitocin, in combination with a foley catheter, is more effective at inducing labor in patients with a gravid BMI that is considered obese.

Vocalization and Spontaneous Pushing in the Second Stage of Labor

The second stage of labor, defined as the period from full cervical dilatation to fetal birth, is a critical phase in which maternal pushing techniques may significantly affect maternal and neonatal outcomes (1-5). Evidence indicates that directed Valsalva pushing may be associated with maternal apnea, increased fatigue, pelvic floor injury, and adverse fetal effects, whereas spontaneous pushing with an open glottis supports physiological birth processes (2,5-11). The World Health Organization recommends encouraging women to follow their natural pushing urges and supports the use of open-glottis pushing techniques to promote a positive childbirth experience (12). Vocalization pushing is an open-glottis maneuver involving intentional low-tone sound production during exhalation, which may facilitate pelvic floor relaxation, improve pain management, and enhance the birth experience (9-11). However, evidence regarding the effectiveness of vocalization pushing is limited, and data from Türkiye are lacking. This randomized controlled clinical trial aims to evaluate the effects of vocalization and spontaneous pushing techniques during the second stage of labor on labor duration, pain intensity, perineal trauma, maternal fatigue, and childbirth experience.

The Effect of Chocolate Consumption During Labor on Second Stage Duration

Childbirth is an energy-intensive physiological process, requiring sustained effort comparable in intensity to moderate physical activity. Studies suggest that providing an available energy source during labor, such as dextrose infusion or natural carbohydrate-rich foods such as dates, may shorten the duration of labor and improve cervical dilation without adversely affecting obstetric outcomes. The primary objective of the study is to examine whether giving chocolate during labor affects the duration of the second stage of labor, compared to a control group that will not receive a nutritional intervention. The study is a prospective, randomized, controlled trial that will be conducted in the delivery room of Hillel Yaffe Medical Center. Healthy pregnant women with a singleton pregnancy at ≥37 weeks gestational age, in spontaneous or induced labor, without diabetes (pre/gestational), will be recruited to participate. Participants in the intervention group will receive one serving of 50 grams of milk chocolate (cocoa content 25-30%, without filling or additives) at a cervical dilation of 6 cm or more (and not yet fully dilated). The mother will be asked to consume the serving gradually over 30 minutes. Milk chocolate was chosen because it is better tolerated compared to dark chocolate, has a more gentle profile of active ingredients (which can increase nausea and heartburn) and provides a source of available carbohydrates. The study will be conducted in accordance with the guidelines of the Ministry of Health's procedure for medical experiments on humans, and will be conducted after approval by the Institutional Helsinki Committee.

Impact of Prophylactic Ephedrine on Fetal Heart Tracing and Uterine Tetanic Contraction After CSE

Labor analgesia is an important component of the care of laboring patients. A known side effect of combined spinal and epidural anesthesia (a type of labor analgesia) is an increased incidence of category II fetal heart rate tracing (defined below) and low blood pressure. The study team aims to study if a prophylactic dose of ephedrine will decrease the occurrence of this type of tracing after combined spinal epidural (CSE) anesthesia placement. Ephedrine is not currently routinely used as prevention for category II tracings or low blood pressure. The use of Ephedrine in this study is investigational (this is the first time that the drug has been studied for its effect on these conditions). Fetal heart rate (FHR) tracings are classified into three categories. In clinical practice, FHR tracing categories are used as a guide to obstetric management and suggest the following approach: * Category I tracing is "reactive" and reassuring → may continue labor * Category II tracing is neither category I nor category III. For obvious reasons, category II is the broadest and largest category, consisting of various FHR tracing patterns that do not fit into either category I or category III. * Category III tracing is non-reassuring → expedited vaginal or cesarean delivery recommended. A Category II tracing is not diagnostic. Most pregnancies have at least one Category II tracing. There is not always an identifiable reason for a Category II tracing. Ephedrine is a medication that causes an increase in heart rate and blood pressure while also causing some degree of relaxation of the uterus therefore improving uterine blood flow. It has been used in the obstetric population for over 50 years without issues. The dose that the research team will administer, 7.5 mg, is below the dose the research team will often administer to treat hypotension (low blood pressure).

The Effect of Using Peanuts Balls at Birth

The necessity of applying the research on humans, whether the application has been done in our country or in other countries before, if it has been done, additional data expected from this study or differences from this study from others, and the expected benefits, please explain within the framework of scientific data. With this planned study, it is aimed to increase the activities of pregnant women during birth by using peanut balls during the birth process, to support the pregnant women psychologically, to reduce labor pains, to shorten the duration of normal birth, to increase self-efficacy for normal birth, to reduce cesarean section rates, to increase labor satisfaction, to reduce fear of birth, to expand the pelvic diameter, to stretch the pelvic muscles and to provide positive gains on connective tissues. With this planned study, it is aimed to reduce labor pain, to shorten the duration of labor and to increase the self-efficacy of the pregnant women for vaginal birth by using peanut balls during the birth process and benefiting from the stated benefits. When the literature review was done, it was determined that partial studies were conducted on the effect of peanut balls on birth in Turkey and in the world, and it was determined that peanut balls are not used in delivery rooms in Turkey despite having many benefits on birth. This study aims to pioneer the widespread use of peanut balls in Turkey. This study was planned to determine the effect of using peanut balls on labor duration, perceived labor pain and self-efficacy in primiparous pregnant women with a cervical dilation of 4 cm and above, in line with the vaginal birth plan. The aim of the planned study is to evaluate the effect of changing position with peanut balls during labor on perceived labor pain, labor duration and self-efficacy levels for normal birth. The hypotheses of the study proposed for this purpose are; H1: Labor pain, duration and self-efficacy of pregnant women who use peanut balls during labor are different from the control group. H2: Perceived labor pain decreases in pregnant women who use peanut balls during labor compared to the control group. H3: The duration of labor (the time period from the active phase to the completion of the transition phase) is shortened in pregnant women who use peanut balls during labor compared to the control group. H4: The duration of labor (the second stage of labor) is shortened in pregnant women who use peanut balls during labor compared to the control group. H5: Using peanut balls during birth increases the self-efficacy level in pregnant women compared to the control group. The peanut ball will be applied in 6 different positions. These positions will consist of side-lying positions, half-sitting pose, forward bending pose and squatting positions. The positions to be applied are planned as in-bed. Pregnant women will be informed about the positions to be applied. The peanut ball will be applied for 20-25 minutes and a 5-10 minute break will be given. The introductory and obstetric information form will be filled out once for each patient. The partograph will be started with the start of the peanut ball use and will end with the end of labor. The visual comparison scale (VAS) and the self-efficacy scale for normal labor will be used 3 times in this study. It will be applied when the dilation is 4 cm and below before the application, immediately after the peanut ball application and half an hour after the peanut ball application.

The Effect of Pregnant-controlled Sacral Massage on Mothers' Labor Pain, Perception, Process and Midwives' Satisfaction

Our study aims to determine the effect of pregnant-controlled automatic sacral massage on mothers' labor pain, perception, process and midwives' satisfaction. The research was planned as a randomized controlled experimental study. A total of 112 women, 56 pregnant women in the experimental and control groups, will be included in the study. In this project, an automatic massage device will be used during the active phase (when the cervical opening is between 5-6 cm and 10 cm) and a massage device in line with the pregnancy-controlled sacral massage application protocol. Pregnant women are followed throughout the active phase of labor and indicators reflecting labor pain, progress of labor, and the health status of the mother and the baby are used with the "Individual Identification Form", "Visual Comparison Scale", "Labor Monitoring Form", "Mother's Birth Perception Scale (ADAS)". The satisfaction of midwives will be evaluated with the "Evaluation of Satisfaction Status of Midwives Form".

The Effect of Stress Ball on Labor Pain, Anxiety and Satisfaction in Labor

The aim of this study was to determine the effect of stress ball use during labor on labor pain, anxiety and satisfaction levels in women admitted to Karabük Training and Research Hospital for delivery. H1 Using the Stress Ball in Labor reduces labor pain. H2 Using the Stress Ball in Labor Reduces Anxiety H3 Use of Stress Ball in Labor increases labor satisfaction.