The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

The effect of foot reflexology on duration of labor and neonatal Apgar score in nulliparous women: a randomized clinical trial

Document Type : Original Article

Authors
Mahboubeh Valiani 1
Maryam Kianpour 1
Elaheh Shiran 2
1 PhD of Clinical Sciences, Nursing and Midwifery Care Research Centre, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
2 M.Sc. in Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
10.22038/ijogi.2022.20097
Abstract
Introduction: One of the risk factors for low Apgar score at birth is duration of labor and its increase. Todays, various pharmachological and non-pharmachological methods are used to reduce labor pain and also the duration of labor. One of these effective methods is reflexology (hand message on feet) during labor which reduces labor pain. Therefore, this study was performed with aim to evaluate the effectiveness of this method on duration of labor and neonatal Apgar score and compare it with the routine care of hospital.
Methods: This quasi-experimental randomized controlled clinical trial study was performed in 2009-2010 on 88 pregnant women referred to Shahid Beheshti and Asgariyeh hospitals in Isfahan for vaginal delivery. The subjects were randomly divided into two groups of intervention (reflexology) and control (routine care). Data collection tool was a questionnaire consisting of two parts of personal characteristics (age, place of residence, occupation, education level) and gestational age and the second part was related to duration of labor and delivery outcome (first and fifth minute Apgar score). Data were analyzed by SPSS software (version 18) and Chi-square and variance analysis tests. P<0.05 was considered statistically significant.
Results: Mean first and fifth minutes Apgar scores after birth was not statistically significant between the two groups (P<0.001). The length of active phase of labor was significantly different between the two groups. In the reflexology group, the length of active phase of labor was shorter than this time in routine care group, but this difference was not significant during the second (p=0.29) and third stages (p=0.27)
Conclusion: Foot reflexology directly reduce the labor duration and labor pain which is effective in contribute to shorten the prevalence of asphyxia and improving the Apgar score.
Keywords
Neonatal Apgar
Nulliparous
Musculoskeletal manipulation
Trial of labor
  1. Hajipour L, Ziaei S, Pouresmaeil Z, Kazemnejad A. The influence of acupuncture on labor pain. Daneshvar Medicine 2007; 15(71):25-30.
  2. Islami Z, Fallah R. Evaluation of the Apgar score and its related factors in neonates born in hospitals of Yazd. SSU_Journals 2009; 16(5):40-5.
  3. Ajduk A, Zernicka-Goetz M. Quality control of embryo development. Molecular aspects of medicine 2013; 34(5):903-18.
  4. Grünebaum A, McCullough LB, Sapra KJ, Brent RL, Levene MI, Arabin B, et al. Apgar score of 0 at 5 minutes and neonatal seizures or serious neurologic dysfunction in relation to birth setting. American Journal of obstetrics and Gynecology 2013; 209(4):323-e1.
  5. Salustiano EM, Campos JA, Ibidi SM, Ruano R, Zugaib M. Low Apgar scores at 5 minutes in a low risk population: maternal and obstetrical factors and postnatal outcome. Revista da Associação Médica Brasileira 2012; 58:587-93.
  6. Shahgheibi S, Rezaie M, Ardalannia M, Zandvakili F, Gharibi F. The relationship between fetal gender and outcome of pregnancy in the term pregnant women. Scientific Journal of Kurdistan University of Medical Sciences 2014; 19(3).
  7. Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants. New England Journal of Medicine 2001; 344(7):467-71.
  8. Hardani AK, Nili F, Shariat M, Nayeri F, Dalili H. Conventional versus combined apgar scores in neonatal asphyxia: a prospective study. Tehran University Medical Journal 2015; 72(10):717-22.
  9. Ehrenstein V. Association of Apgar scores with death and neurologic disability. Clinical epidemiology 2009; 1:45-53.
  10. Ruth VJ, Raivio KO. Perinatal brain damage: predictive value of metabolic acidosis and the Apgar score. British Medical Journal 1988; 297(6640):24-7.
  11. Hegyi T, Carbone T, Anwar M, Ostfeld B, Hiatt M, Koons A, et al. The Apgar score and its components in the preterm infant. Pediatrics 1998; 101(1):77-81.
  12. Nystedt A, Hildingsson I. Diverse definitions of prolonged labour and its consequences with sometimes subsequent inappropriate treatment. BMC pregnancy and childbirth 2014; 14(1):1-11.
  13. Pirhadi M, Valiani M, Azimi M. Effect of Auriculotherapy on Neonatal Apgar Score and Maternal Postpartum Hemorrhage and Vital Signs. Iran J Obstet Gynecol Infertil 2018; 21(6):27-33.
  14. Zare S, Zandvakili F, Soofizade N, Farhadifar F, Sadrinezhad A. Evaluation of the causes and maternal and fetal complications in prolonged pregnancy compared with term pregnancy in Sanandaj Besat hospital during 2013-2014. Iran J Obstet Gynecol Infertil 2017; 20(10):29-34.
  15. Heidari P, Mojdeh F, Mazloom R, Tanbakoi K, Judaki K. Effect of acupressure on labor pain intensity. Hakim Research Journal 2008; 11(2):39-46.
  16. Rahimikian F, Talebi F, Golian Tehrani S, Mehran A. Comparison of the effect of physiological birth and routine normal delivery on some of maternal and fetus outcomes. Journal of Ardabil University of Medical Sciences 2013; 13(4):398-405.
  17. McNeill JA, Alderdice FA, McMurray F. A retrospective cohort study exploring the relationship between antenatal reflexology and intranatal outcomes. Complementary Therapies in Clinical Practice 2006; 12(2):119-25.
  18. Mirzaee F, Kaviani MA, Jafari PE. Effect of reflexology on anxiety level in nuliparous women. Hayat 2010; 16(1):65-71.
  19. Moghimi-Hanjani S, Mehdizadeh-Tourzani Z, Shoghi M. The effect of foot reflexology on anxiety, pain, and outcomes of the labor in primigravida women. Acta Medica Iranica 2015: 507-11.
  20. Ben-Horin I, Kahan P, Ryvo L, Inbar M, Lev-Ari S, Geva R. Acupuncture and reflexology for chemotherapy-induced peripheral neuropathy in breast cancer. Integrative cancer therapies 2017; 16(3):258-62.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 1
March 2022
Pages 46-55