Labour PainNCT06214585
Effect of Intermittent Heat and Cold Therapy on Comfort During Labor
A study testing Intermittent heat and cold versus heat-only therapy and Heat- only Therapy in people with Labour Pain and Cold Therapy, run by Tribhuvan University, Nepal at 1 site in Nepal.
Trial summary
Summary of the Study Childbirth is one of the most significant and complex experiences in any mother's life. According to a study, labour pain ranges from mild to severe and is felt throughout the body, particularly in the lower abdomen, vagina, and around the waist. Read more about this study
- Who is it for?
- Ages 18 to 35 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Labour Pain, Cold Therapy, Heat Therapy
- What is being tested?
- Intermittent heat and cold versus heat-only therapy and Heat- only Therapy
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 159 participants
- Where
- 1 siteNepal
- Study dates
- 26 Feb 2024to 16 Aug 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 35 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- Low-risk primigravida are those pregnant women who are between the ages of 18 to 35 years old admitted to Bhartpur hospitals and anticipated normal delivery.
- Completed 4 ANC visits
- Normal size fetus and without any complication by USG scan
- Weeks of gestation 37 to 41
- No history of abortions
- Who had not taken any analgesic and other regular medication
Show all 9Show fewer
- Normal BMI (Pre-pregnancy 18.5-24.9)
- Women willing to participate
- Those mothers who are initial phase of labor
Who cannot join
- Pregnant women who had a history of abortion
- Pregnancy-induced hypertension and heart conditions(pre/eclampsia)
- Antepartum haemorrhage
- Pregnancy with urinary system disease such as UTI
- Hyper or hypothyroidism
- Anemia
Show all 14Show fewer
- Obesity
- Pregnancy with Diabetes
- Diagnosed Mental Illnesses such as Stress anxiety depression, Psychosis or epilepsy
- Any Physical Disability
- Fever during Labor
- Those pregnant women who did not have any antenatal visit
- Pregnant women who will not willing to participate
- Those women who develop complications during the study
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effect of Intermittent Heat & Cold Versus Heat Only Therapy on Comfort and Duration of Labor Among Primigravida
Summary of the Study Childbirth is one of the most significant and complex experiences in any mother's life. According to a study, labour pain ranges from mild to severe and is felt throughout the body, particularly in the lower abdomen, vagina, and around the waist. The mean pain perception of the prurient as assessed by the Visual Analog scale (VAS) was 7.0 with a range of 1.2-10.0. In a study, 50% of parturients rated labour pain as severe (VAS > 7.1). The majority of the respondents 86.4% desired some form of pain relief. Pain relief during labor is a crucial component of the labor process. Non-drug techniques for alleviating labor pain focus on psychological and physical discomfort elements. A study in Panjab was performed to assess the effectiveness of heat therapy on the lower back among women in labor pain during the first stage of labor and found that heat therapy reduces the severity of pain in the first stage of labor. A study performed in India found that intermittent heat and cold therapy successfully shorten the first and second stages of labor's duration and pain. The purpose of the study is to compare the impact of intermittent heat and cold therapy with heat-only therapy on comfort and duration of labor among primigravida women at a Bharatpur hospital in Nepal.
A quantitative research approach will be adopted and the research design will be a true experimental pretest posttest design. It will be conducted among 150 low-risk primigravida women aged 20 to 35 years with a gestation of 37-41 weeks of pregnancy admitted to the maternity of Bharatpur Hospital, Chitwan Nepal who are anticipated to deliver spontaneously. The participants will be divided into 50 in each 3 groups. One group will receive intermittent heat and cold therapy, another group will receive heat-only therapy and one group will be the control group. The tool will be a standard tool which are Visual Analog Scale (VAS) and Childbirth Comfort Questionnaire (CCQ). All the ethical clearance will be obtained before collecting data from Sharda University, Nepal Health Research Council, and Bharatpur Hospital. Informed consent will be taken from all the participants and their rights, privacy, confidentiality, and comfort will be maintained. The participants can withdraw from the study at any time without giving any explanation. The data will be organized and entered into Statistical Package of Social Sciences (SPSS) version 16 for analysis. The data will be analyzed according to the objectives of the study by using descriptive and inferential statistics.
Read the detailed description
Heat Only Therapy A 2-liter rubber hot water bag will be utilized to provide heat to the lower back of primigravida women during the first stage of labor. The water in the bag will be maintained at a temperature of 40-42ºC. The application of heat will last for 20 minutes, and it will be repeated every hour until the cervix is fully dilated. To prepare the hot water, tap water will be boiled in a stainless steel pot until it reaches 70ºC. Before filling the hot water bag, its temperature will be verified using a laboratory thermometer. The bag will then be covered with a towel and applied to the laboring women, ensuring the heat is tolerable for her. If the temperature falls below the specified range, another hot water bag will be made ready for replacement. Intermittent Heat \& Cold Therapy During the first stage of labor (from 4-5 to 10 cm of cervical dilation) for the experimental group, a cyclical method of alternating heat and cold application will be used on the lumbosacral and lower abdominal area of the laboring women. The process involves applying a hot pack with a temperature range of 38-40°C on their lower abdomen and low back for 30 minutes during contractions and a relaxing period using a 2-litre rubber hot water bag.
Subsequently, reusable ice packs typically contain water, covered with a towel and with a temperature range of 0-5°C will be applied to the same areas for 10 minutes. After a 30-minute interval, the heat application will be reapplied, and this alternating heat and cold cycle will be repeated throughout the first stage of the laboring process. After interventions 4-5, 7-8 and 9-10 cm of cervical dilation, we will assess the comfort including pain level and after 10 cm of cervical dilation, duration will be calculated to identify the total duration of first stage of labor
- Conditions
- Labour Pain, Cold Therapy, Heat Therapy
- Being tested
- Intermittent heat and cold versus heat-only therapy, Heat- only Therapy
- Keywords
- Comfort, Cold , Heat Therapy, Labor Pain
- Medical subject headings
- Labor Pain, Hyperthermia, Common Cold
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Intermittent heat and cold versus heat-only therapyProcedure or surgery
for the experimental group, a cyclical method of alternating heat and cold application will be used on the lumbosacral and lower abdominal area of the laboring women. The process involves applying a hot pack with a temperature range of 38-40°C on their lower abdomen and low back for 30 minutes during contractions and a relaxing period using a 2-litre rubber hot water bag. Subsequently, reusable ice packs typically contain water, covered with a towel and with a temperature range of 0-5°C will be applied to the same areas for 10 minutes. After a 30-minute interval, the heat application will be reapplied, and this alternating heat and cold cycle will be repeated throughout the first stage of the laboring process.
Heat- only TherapyProcedure or surgery
hot water bag will be used to provide heat to the lower back of primigravida women during the first stage of labor. The water in the bag will be maintained at a temperature of 40-42ºC. The application of heat will last for 20 minutes, and it will be repeated every hour until the cervix is fully dilated.
| Study group | Role | What they receive |
|---|---|---|
| Intermittent Heat & cold Therapy | Experimental | There will be one group that will be receiving warm water application on the mother's back and then receiving ice pack application on the same region. Receives: Procedure: Intermittent heat and cold versus heat-only therapy; Procedure: Heat- only Therapy |
| Heat- Only Therapy | Experimental | This group of mothers will receive a warm application by hot water bag only on her back Receives: Procedure: Intermittent heat and cold versus heat-only therapy; Procedure: Heat- only Therapy |
| Control Group | No intervention | This group will receive just standard care as hospital protocol |
What is being measured
The primary outcome is the main question the study is designed to answer.
Level of Comfort
It will be measured using Childbirth Comfort Questionnaire.The Childbirth Comfort Questionnaire (CCQ) was developed and tested in 2002-2003. Face validity was accomplished by a panel of experts: midwives, obstetricians, labor and delivery nurses and women who had given birth. The instrument has a 0.71 Cronbach's (sample size n = 64). The instrument is administered twice during labor: latent \& active phase. To score, reverse code the negative responses and total the sum. Higher totals mean higher comfort.
Measured: 1 to 2 hours of intervention
Duration of Labor
Duration of labor will be measured using a partograph. The initiation of labor time to completion labor process will be recorded in the partograph. At the end of the first labour stage, the total labour hour will be caculated and mentioned as mean duration which will be compared with other data
Measured: 4 to 5 hours
Level of labor pain
A Visual Analogue Scale will be used as the pain rating scale used for the first time in 1921 by Hayes and Patterson. There is no pain" on the far left and "the most intense pain imaginable" on the far right. In between these two extremes, words such as mild, moderate, severe, and very severe pain are assigned to each 2 cm distance on the line, respectively.
Measured: 1 to 2 hours of intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Jan 2024
- Study start26 Feb 2024
- Primary completion1 Aug 2024
- Study completion16 Aug 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Labour PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 159 participants (actual)
Sponsor and investigators
- Lead sponsor
- Tribhuvan University, Nepal
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Isabel Lawot, Tribhuvan University, Nepal
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06214585
- Sponsor's protocol ID
- ShardaU
- Status last verified
- Sep 2024
- First submitted
- 14 Dec 2023
- Last updated
- 27 Sep 2024
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 27 Sep 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Intermittent Heat & Cold Versus Heat Only Therapy on Comfort and Duration of Labor Among Primigravida
- ClinicalTrials.gov ID
- NCT06214585
- Acronym / sponsor ID
- ShardaU
- Conditions
- Labour Pain, Cold Therapy, Heat Therapy
- Keywords
- Comfort, Cold , Heat Therapy, Labor Pain
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 159 participants (actual)
- Lead sponsor
- Tribhuvan University, NepalUniversity, hospital or other
- Study start
- 26 Feb 2024 (actual)
- Primary completion
- 1 Aug 2024 (actual)
- Study completion
- 16 Aug 2024 (actual)
- First posted
- 19 Jan 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Summary of the Study Childbirth is one of the most significant and complex experiences in any mother's life. According to a study, labour pain ranges from mild to severe and is felt throughout the body, particularly in the lower abdomen, vagina, and around the waist. The mean pain perception of the prurient as assessed by the Visual Analog scale (VAS) was 7.0 with a range of 1.2-10.0. In a study, 50% of parturients rated labour pain as severe (VAS > 7.1). The majority of the respondents 86.4% desired some form of pain relief. Pain relief during labor is a crucial component of the labor process. Non-drug techniques for alleviating labor pain focus on psychological and physical discomfort elements. A study in Panjab was performed to assess the effectiveness of heat therapy on the lower back among women in labor pain during the first stage of labor and found that heat therapy reduces the severity of pain in the first stage of labor. A study performed in India found that intermittent heat and cold therapy successfully shorten the first and second stages of labor's duration and pain. The purpose of the study is to compare the impact of intermittent heat and cold therapy with heat-only therapy on comfort and duration of labor among primigravida women at a Bharatpur hospital in Nepal.
A quantitative research approach will be adopted and the research design will be a true experimental pretest posttest design. It will be conducted among 150 low-risk primigravida women aged 20 to 35 years with a gestation of 37-41 weeks of pregnancy admitted to the maternity of Bharatpur Hospital, Chitwan Nepal who are anticipated to deliver spontaneously. The participants will be divided into 50 in each 3 groups. One group will receive intermittent heat and cold therapy, another group will receive heat-only therapy and one group will be the control group. The tool will be a standard tool which are Visual Analog Scale (VAS) and Childbirth Comfort Questionnaire (CCQ). All the ethical clearance will be obtained before collecting data from Sharda University, Nepal Health Research Council, and Bharatpur Hospital. Informed consent will be taken from all the participants and their rights, privacy, confidentiality, and comfort will be maintained. The participants can withdraw from the study at any time without giving any explanation. The data will be organized and entered into Statistical Package of Social Sciences (SPSS) version 16 for analysis. The data will be analyzed according to the objectives of the study by using descriptive and inferential statistics.
Detailed description
Heat Only Therapy A 2-liter rubber hot water bag will be utilized to provide heat to the lower back of primigravida women during the first stage of labor. The water in the bag will be maintained at a temperature of 40-42ºC. The application of heat will last for 20 minutes, and it will be repeated every hour until the cervix is fully dilated. To prepare the hot water, tap water will be boiled in a stainless steel pot until it reaches 70ºC. Before filling the hot water bag, its temperature will be verified using a laboratory thermometer. The bag will then be covered with a towel and applied to the laboring women, ensuring the heat is tolerable for her. If the temperature falls below the specified range, another hot water bag will be made ready for replacement. Intermittent Heat \& Cold Therapy During the first stage of labor (from 4-5 to 10 cm of cervical dilation) for the experimental group, a cyclical method of alternating heat and cold application will be used on the lumbosacral and lower abdominal area of the laboring women. The process involves applying a hot pack with a temperature range of 38-40°C on their lower abdomen and low back for 30 minutes during contractions and a relaxing period using a 2-litre rubber hot water bag.
Subsequently, reusable ice packs typically contain water, covered with a towel and with a temperature range of 0-5°C will be applied to the same areas for 10 minutes. After a 30-minute interval, the heat application will be reapplied, and this alternating heat and cold cycle will be repeated throughout the first stage of the laboring process. After interventions 4-5, 7-8 and 9-10 cm of cervical dilation, we will assess the comfort including pain level and after 10 cm of cervical dilation, duration will be calculated to identify the total duration of first stage of labor
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Intermittent Heat & cold Therapy | Experimental | Procedure: Intermittent heat and cold versus heat-only therapy, Procedure: Heat- only TherapyThere will be one group that will be receiving warm water application on the mother's back and then receiving ice pack application on the same region. |
| Heat- Only Therapy | Experimental | Procedure: Intermittent heat and cold versus heat-only therapy, Procedure: Heat- only TherapyThis group of mothers will receive a warm application by hot water bag only on her back |
| Control Group | No intervention | –This group will receive just standard care as hospital protocol |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (9 listed)
- Low-risk primigravida are those pregnant women who are between the ages of 18 to 35 years old admitted to Bhartpur hospitals and anticipated normal delivery.
- Completed 4 ANC visits
- Normal size fetus and without any complication by USG scan
- Weeks of gestation 37 to 41
- No history of abortions
Key exclusion criteria (14 listed)
- Pregnant women who had a history of abortion
- Pregnancy-induced hypertension and heart conditions(pre/eclampsia)
- Antepartum haemorrhage
- Pregnancy with urinary system disease such as UTI
- Hyper or hypothyroidism
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Intermittent heat and cold versus heat-only therapyfor the experimental group, a cyclical method of alternating heat and cold application will be used on the lumbosacral and lower abdominal area of the laboring women. The process involves applying a hot pack with a temperature range of 38-40°C on their lower abdomen and low back for 30 minutes during contractions and a relaxing period using a 2-litre rubber hot water bag. Subsequently, reusable ice packs typically contain water, covered with a towel and with a temperature range of 0-5°C will be applied to the same areas for 10 minutes. After a 30-minute interval, the heat application will be reapplied, and this alternating heat and cold cycle will be repeated throughout the first stage of the laboring process. | Procedure or surgery | Heat- Only Therapy, Intermittent Heat & cold Therapy |
| Heat- only Therapyhot water bag will be used to provide heat to the lower back of primigravida women during the first stage of labor. The water in the bag will be maintained at a temperature of 40-42ºC. The application of heat will last for 20 minutes, and it will be repeated every hour until the cervix is fully dilated. | Procedure or surgery | Heat- Only Therapy, Intermittent Heat & cold Therapy |
Primary outcome
Level of Comfort
Time frame: 1 to 2 hours of intervention
It will be measured using Childbirth Comfort Questionnaire.The Childbirth Comfort Questionnaire (CCQ) was developed and tested in 2002-2003. Face validity was accomplished by a panel of experts: midwives, obstetricians, labor and delivery nurses and women who had given birth. The instrument has a 0.71 Cronbach's (sample size n = 64). The instrument is administered twice during labor: latent \& active phase. To score, reverse code the negative responses and total the sum. Higher totals mean higher comfort.
Duration of Labor
Time frame: 4 to 5 hours
Duration of labor will be measured using a partograph. The initiation of labor time to completion labor process will be recorded in the partograph. At the end of the first labour stage, the total labour hour will be caculated and mentioned as mean duration which will be compared with other data
Level of labor pain
Time frame: 1 to 2 hours of intervention
A Visual Analogue Scale will be used as the pain rating scale used for the first time in 1921 by Hayes and Patterson. There is no pain" on the far left and "the most intense pain imaginable" on the far right. In between these two extremes, words such as mild, moderate, severe, and very severe pain are assigned to each 2 cm distance on the line, respectively.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Sep 2024.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Intermittent heat and cold versus heat-only therapy and Heat- only Therapy in people with Labour Pain and Cold Therapy, run by Tribhuvan University, Nepal at 1 site in Nepal.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 27 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Nepal. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Level of Comfort (time frame: 1 to 2 hours of intervention). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Sep 2024.