American Journal of Obstetrics & Gynecology, 2020/01, 222(1):S657-S658. doi: 10.1016/j.ajog.2019.11.1078, type of study: ,obs,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.ajog.org/article/S0002-9378(19)32448-2/abstract)

Keywords:

pregnancy outcome [4]
obstretical management [1]
uterine cervix dilatation [1]
labor duration [3]
obstetrician [1]
female [655]
hospital patient [1]
labor management [1]
osteopathic manipulative treatment [3946]
OMT [3925]
observational study [246]
conference abstract [127]

Abstract:

Objective: Although widely used in pregnancy, the effects of osteopathic manipulative treatment (OMT) on labor duration remain unclear. The purpose of this study was to evaluate the effect of OMT on labor duration when applied in tandem with obstetrical management in the inpatient setting. Study Design: We conducted a prospective observational study from June 2017 through September 2018. We included all patients who received OMT as part of their labor management in the inpatient setting. These patients were matched with controls who did not receive OMT in the same time frame. OMT protocol involved a single administration at time of admission of suboccipital decompression, thoracic inlet release, rib raising, paraspinal inhibition, and sacral inhibition. Overall duration of OMT was 20 minutes. Obstetrical decisions regarding labor management for both groups were made by one senior obstetrician. Results: The study included 262 patients, with 124 patients receiving OMT and 138 receiving routine obstetrical care. Baseline characteristics were not statistically significant between groups. The OMT group was noted to have a shorter duration of first stage of labor (10.7 hours versus 11.6 hours, p = 0.021) as well as an overall shorter duration of total labor time (13.1 hours versus 14.1 hours, p = 0.015). After adjusting for perceived confounding factors including age, body mass index, maternal age >34 years, gestational age, race, parity, stage of labor, cervical dilation at time of presentation, gestational blood pressure >140/90 mm Hg, and pregestational diabetes, this effect was still noted for both first stage and total labor duration (p = 0.044 and 0.037, respectively. Kaplan-Meier survival analysis was performed to compare labor curves between each group and was noted to be significantly different with the OMT group having an overall shorter duration of labor (p = 0.023). Conclusion: In this prospective study, OMT performed in tandem with obstetrical management provides a safe and efficient way to reduce labor duration in the inpatient setting.