LAUSR

Labor is regarded as one of the important events that women experience and always remember. Therefore, the negative experience of labor for a mother and her family has unfavorable emotional and mental effects (1, 2). In addition, prolonged labor is a crucial clinical problem in modern midwifery and creates numerous challenges for mother and infant (3) such that shortening the duration of labor is considered as one of the ongoing concerns of the specialists (4). Prolonged labor, bleeding, and infection are the most essential causes of maternal mortality in labor and early post-delivery days (5). Further, prolonged duration of the first stage of labor is accompanied by fetal (e.g., pressure on the head, disrupted oxygen supply, low Apgar, and ultimately, fetal mortality) and maternal (e.g., bleeding, post-delivery infection, anxiety-induced confusion, sleeplessness, and fatigue) complications (6). The prevalence of prolonged labor is 3-8 percent, which is three times higher in nulliparous women compared to multiparous women (7). Given the outcomes of prolonged labor, difficult labor is the most common cause of going through primary cesarean (C) section (8). To reduce the duration of the first stage of labor and prevent prolonged labor complications, various solutions are suggested such as using oxytocin, hyoscine, and pethidine medicines. However, these might create different side-effects like dry mouth, facial flushing, dry skin, photophobia, urge incontinence, urinary retention, and constipation (9). Hyoscine n-butylbromide is a muscarinic antagonist which is used for cervical spasm relief with a total clearance of 1.2 L/min. Its side-effects include dry mouth, facial flushing, dry skin, photophobia, urge incontinence, urinary retention, and constipation (10). Some studies reported a 30%-40% reduction in the duration of labor following hyoscine administration (11, 12). The results of Aggarwal et al (13) and Sirohiwal et al (11) showed that hyoscine shortened the duration of the first stage of labor. The use of non-drug methods (e.g., acupressure) is another way of reducing the duration of labor, which is preferred over drug methods because of its Abstract Objectives: The shortened duration of labor without creating major complications is considered ideal for the mother and infant while prolonged labor is accompanied by maternal and fetal consequences. Considering its importance, the purpose of this study was to compare the effects of acupressure at the Hugo point and hyoscine on the duration of labor stages and fetal-neonatal outcomes in nulliparous women. Methods: This controlled randomized clinical trial was conducted on 162 nulliparous women who referred to Ardabil Sabalan Hospital in 2017. Participants were divided into Hugo acupressure, hyoscine, and control groups by means of randomized blocks, each containing 54 nulliparous women. In the Hugo group, the pressure exerted on the Hugo point at 5 cm dilatation and in the hyoscine group, the hyoscine was injected intramuscularly at 5 cm dilatation. Data were analyzed using one-way ANOVA, KruskalWallis, Fisher exact, and chi-square tests. Results: The mean (SD) duration of the active phase of labor was 137.0 (15.1), 143.3 (172), and 187.7 (24.7) minutes in the Hugo, hyoscine, and control groups, respectively. In addition, the mean (SD) duration of the second stage of labor in the above-mentioned groups was 39.5 (8.5), 52.4 (15.0), and 58.3 (8.7) minutes, respectively (P < 0.001). Conclusions: Overall, the implementation of acupressure at the Hugo point led to a greater reduction in the duration of labor stages compared to hyoscine infusion without imposing the side-effects on mother.