Read and PICO the following abstract. Match the part of the
Read and PICO the following abstract. Match the part of the abstact… Read and PICO the following abstract. Match the part of the abstact to its appropriate part of PICO. (A little background- in labor and delivery, closed glottis pushing has been historically used- you can consider it the “usual care.” Research is currently being done regarding whether we should continue that practice, or whether there is a better way.)Barasinski, C., et al. (2020). “Is directed open-glottis pushing more effective than directed closed-glottis pushing during the second stage of labor? A pragmatic randomized trial – the EOLE study.” Midwifery 91: 102843.Objective: To compare the effectiveness of directed open-glottis and directed closed-glottis pushing. Design Pragmatic, randomised, controlled, non-blinded superiority study. Settings Four French hospitals between July 2015 and June 2017 (2 academic hospitals and 2 general hospitals).Participants: 250 women in labour who had undergone standardised training in the two types of pushing with a singleton fetus in cephalic presentation at term (=37 weeks) were included by midwives and randomised; 125 were allocated to each group. The exclusion criteria were previous caesarean birth or fetal heart rate anomaly. Participants were randomised during labour, after a cervical dilation = 7 cm. Interventions In the intervention group, open-glottis pushing was defined as a prolonged exhalation contracting the abdominal muscles (pulling the stomach in) to help move the fetus down the birth canal. Closed-glottis pushing was defined as Valsalva pushing.Measurements: The principal outcome was “effectiveness of pushing” defined as a spontaneous birth without any episiotomy, second-, third-, or fourth-degree perineal lesion. The results in our intention-to-treat analysis are reported as crude relative risks (RR) with their 95% confidence intervals. A multivariable analysis was used to take the relevant prognostic and confounding factors into account and obtain an adjusted relative risk (aRR).Findings: In our intention-to-treat analysis, most characteristics were similar across groups including epidural analgesia (>95% in each group). The mean duration of the expulsion phase was longer among the open-glottis group (24.4 min ± 17.4 vs. 18.0 min ± 15.0, p=0.002). The two groups did not appear to differ in the effectiveness of their pushing (48.0% in the open-glottis group versus 55.2% in the closed-glottis group, for an adjusted relative risk (aRR) of 0.92, 95% confidence interval (CI) 0.74-1.14) or in their risk of instrumental birth (aRR 0.97, 95%CI 0.85-1.10).Key conclusions: In maternity units with a high rate of epidural analgesia, the effectiveness of the type of directed pushing does not appear to differ between the open- and closed-glottis groups. Implications for practice If directed pushing is necessary, women should be able to choose the type of directed pushing they prefer to use during birth. Professionals must therefore be trained in both types so that they can adequately support women as they give birth.Match the following -Population Intervention Comparison Outcome A.Effectiveness of pushing B.Open-glottis pushing C.The mean duration of pushing was longer in the open-glottis group D.Closed-glottis pushing E. In maternity units with a high rate of epidural analgesia, the effectiveness of the type of directed pushing does not appear to differ between the open- and closed-glottis groups F.Women in labor with training in pushing Health Science Science Nursing NURS 422
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