The Prince of Songkla University Pain Curve for Predicting Labor Progress (original) (raw)
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Development of a Labour Pain Assessment Instrument
Africa Journal of Nursing and Midwifery
Labour may impose severe pain, yet women experience the intensity of pain differently. The severity of labour pain is frequently underestimated by women, midwives and clinicians. Pain assessment is considered the key to labour pain measurement and a standardised instrument can assist with adequate management of labour pain. Although a variety of pain assessment/measurement tools were found by a search conducted between 2000 and 2010, the tool charts are detailed and require time to complete, they do not cover all aspects of labour, and they avoid quantifying and documentation of labour pain. Developing a new multidimensional labour pain assessment instrument could assist midwives and clinicians with labour pain control. Ethical permission was obtained from the university Faculty Academic Ethics Committee to develop a new labour pain assessment instrument. Six steps of Blackburn and Waite (2006:134) guided development of the instrument that measures pain during the first stage of labour. This exploratory sequential mixed method study, using a qualitative and quantitative research design, described the development process of the new instrument. Four focus groups with four to six members comprising midwifery lecturers, midwives working in the private and public hospitals, midwives in private practice and obstetricians were conducted to develop the instrument. The instrument was thereafter given in two Delphi technique rounds to the most senior persons teaching Midwifery at all South African
Midwifery, 2011
during childbirth, it is necessary to assess and monitor experienced pain and to evaluate the effect of pain relief treatment. The aim of this study was to compare the PainMatcher (PM) with the Visual Analogue Scale (VAS) for the assessment of labour pain and the effect of pain relief treatment. randomised controlled trial. labour ward with approximately 2500 childbirths per year in western Sweden. 57 women with labour pain treated with acupuncture or sterile water injections scored their electrical pain threshold and pain intensity with the PM. Pain intensity was also assessed with the VAS. Electrical pain threshold and pain intensity were assessed immediately after a uterine contraction before and 30, 60, 90, 120, 150 and 180 minutes after treatment. the results showed a weak correlation (r=0.13, p<0.05) between the pain intensity scores on the PM and the VAS. The PM detected changes (decrease) in pain intensity to a lower degree than the VAS. Surprisingly, in over 10% of sessions, women scored their pain intensity during a uterine contraction lower than their electrical pain threshold with the PM. However, electrical pain thresholds with the PM correlated well throughout all measurements. the PM is a reliable tool for the assessment of electrical pain threshold; however, the VAS is more sensitive than the PM for recording changes in pain intensity when assessing the effects of treatment on labour pain. the PM and the VAS are not interchangeable in the case of labour pain, and there is still a need for research in this area to find a more suitable assessment instrument for the evaluation of labour pain.
Measuring the labor pain experience: delivery still far off
International journal of obstetric anesthesia, 2013
Pain is defined as ''an unpleasant sensory and emotional experience associated with actual or potential tissue damage''. 1 Defining pain, however, has proved much easier than measuring pain. This editorial challenges the dogma that a numeric pain rating score is an adequate measurement tool for labor pain experience for both clinical and research assessment, and explores potential reasons why high-quality measures of pain in this setting have been so elusive. Improving the way we quantify pain during labor and measure the entire labor pain experience is important to optimize the provision of labor analgesia, enhance maternal satisfaction and facilitate appropriate obstetric decision-making.
Predictors of severe labor pain: prospective observational study
Introduction: Pain during childbirth is a complex and subjective experience that every mother experiences differently [1]. The degree of a woman's suffering in childbirth depends on the intensity of labor pain and many indirect factors [2]. Complex interrelated effects on labor pain are limited by the little number of studies available. That is why it is necessary to determine the probable factors that may affect the intensity of pain. In accordance with this, determining predictors of the intensity of pain during vaginal delivery remains an important issue for the maternity health policy.Aim: Investigate predictors of severe labor pain.Method: A prospective observational study was conducted in the period from December 2020 to May 2021 at the Kyiv City Maternity Hospital №5 (Kyiv, Ukraine). Logistic regression was used to measure the influence of risk factors on the probability of severe labor pain.Results: The examined predictors were derived from mothers` self-report of overal...
Siriraj Medical Journal, 2019
Objective: To investigate the relationship between cervical length (CL) at gestational age (GA) 37 to 41+6 weeks and delivery within 7 days in term pregnancy patients who presented with labor pain. Methods: Term pregnancy subjects who attended antenatal clinic and delivered at Bhumibol Adulyadej Hospital, between September 2017 and June 2018 were recruited in this study. Participants who met the inclusion criteria received transvaginal ultrasound to measure CL. Clinical and delivery outcomes were followed. Sensitivity, specificity, negative predictive value (NPV) positive predictive value (PPV) and accuracy were calculated to assess the relationship between CL and delivery within 7 days. Results: A total of 106 pregnant women were included in the analysis. The mean age was 26 years. Three-quarters of the cases were nulliparous. The average gestational age at delivery and newborn birth weight were 39 complete weeks and 3,100 grams, respectively. Seventy-six cases successfully delivered within 7 days while 30 patients had to wait for more than 7 days before delivery. The receiver operating characteristic (ROC) curve was used to assess the optimal cutoff of CL. The CL less than 25 mm. gave sensitivity and specificity at 69% and 73%, respectively and gave accuracy of 70.75% in prediction of delivery within 7 days. Conclusion: Transvaginal CL measurement was useful to predict the time of spontaneous delivery and help clinicians to advise the patients about their delivery plans.
Anesthesia & Analgesia, 2016
E pidural analgesia is used in approximately 60% of spontaneous vaginal deliveries each year in the United States and Canada. 1,2 Although new drugs and methods of neuraxial drug administration have emerged over time, the methods used to assess women's pain experiences during childbirth have not evolved with them. This has made it BACKGROUND: The Angle Labor Pain Questionnaire (A-LPQ) is a new, 22-item multidimensional psychometric questionnaire that measures the 5 most important dimensions of women's childbirth pain experiences using 5 subscales: The Enormity of the Pain, Fear/Anxiety, Uterine Contraction Pain, Birthing Pain, and Back Pain/Long Haul. Previous work showed that the A-LPQ has overall good psychometric properties and performance during early active labor in women without pain relief. The current study assessed the tool's sensitivity to change during initiation of labor epidural analgesia with the standardized response mean (SRM, primary outcome). METHODS: Two versions of the A-LPQ were administered once, in each of 2 test sessions, by the same trained interviewer during early active labor. The sequence of administration was randomized (ie, standard question order version [Test 1] followed by mixed version [Test 2] or vice versa). Test 1 was completed before epidural insertion; Test 2 commenced 20 to 30 minutes after the test dose. Providers assessed/treated pain independently of the study. Sensitivity to change was assessed using SRMs, Cohen's d, and paired t tests. Overall pain intensity was concurrently examined using Numeric Rating Scale and the Verbal Rating Scale (VRS); coping was assessed with the Pain Mastery Scale. Changes in pain were measured with the Patient Global Impression of Change Scale. Internal consistency was assessed with Cronbach's α. Concurrent validity with other tools was assessed using Spearman's rank correlation coefficient. RESULTS: A total of 51 complete datasets were analyzed. Most women reported moderate (63%, 32/51) or severe (18%, 9/51) baseline pain on VRS scores during Test 1; 29% (15/51) reported mild pain, and 6% (3/51) reported moderate pain during Test 2. Approximately 90% (46/51) of women reported much or very much improved pain at the end of testing. Cronbach's α for A-LPQ summary scores was excellent (0.94) and ranged from 0.78 (acceptable) to 0.92 (excellent) for subscales (Test 1). Large SRMs were found for A-LPQ summary scores (1.6, 95% CI: 1.2, 2.1) and all subscales except the Birthing Pain subscale (moderate, 0.60, 95% CI: 0.23, 0.97). Significant (P < .001) differences were found between A-LPQ summary scores and between all subscales on paired t tests. Correlations between A-LPQ summary and Numeric Rating Scale scores (overall pain intensity) were strong (ρ > 0.73), correlations were moderate (ρ > 0.5) with VRS scores and coping scores (ρ > 0.67). CONCLUSIONS: Findings support A-LPQ use for measurement of women's childbirth pain experiences during initiation of labor epidural analgesia during early active labor. Combined with our previous work, they also support the use of the A-LPQ in late labor and at delivery.
Evaluation of experimental pain tests to predict labour pain and epidural analgesic consumption
British Journal of Anaesthesia, 2013
Editor's key points † There is some evidence that sensory testing may help predict levels of postoperative pain. † Here, sensory tests are used before induction of labour to try to predict the labour pain experience. † Sensory tests were not very reliable at predicting the labour pain experience. † Considerably more work needs to be done to develop useful tools for identifying high-risk patients.
Labor pain assessment: Validity of a behavioral index
Pain, 1985
There is a need for adequate and convenient measures for assessing obstetric pain. The present investigation was designed to develop a non-verbal objective measurement of labor pain based on the continuous observation of behavior. Validity and sensitivity of the instrument designed to assess pain throughout labor using standardized observational ratings were tested on a sample of 100 primiparae who were asked periodically to rate pain on a 5-point numerical scale. The use of a behavioral method of observation associated with a self-rating procedure comprises various advantages, especially because they may appreciate different factors of the pain experience. Behavioral and self-rating indices were satisfactorily correlated. The behavioral index correlates with the pre-partum anxiety score but the self-rating index does not. The positive results obtained in this preliminary study lead us to consider this behavioral index as a valid instrument. Correspondence and reprint requests to: A.M. Bonnel, Dkpartement de Psychologie Expkimentale, Universitt de Provence, 29, Av. R. Schuman, 13621 Aix en Provence Cedex, France. 0304-3959/85/$03.30 0 1985 Elsevier Science Publishers B.V. (Biomedical Division)
Correlation between subjective labour pain and uterine contractions: a clinical study
Pain, 1986
women underwent tocography during the second phase of the first stage of labour in order to evaluate the main characteristics of their uterine contractions (intensity, duration and pattern). At the end of each contraction, for a total of about 8 contractions per woman and an overall total of 125 tocographic curves, each woman was asked to make a subjective evaluation of the pain felt during that contraction using a 10 cm visual analogue scale (VAS). All the tocographic curves corresponding to the contractions studied were elaborated mathematically to determine the peak (intensity), base (duration) and area under the curve (AUC).