Brief Report  |   June 2019
Effect of Osteopathic Obstetrical Management on the Duration of Labor in the Inpatient Setting: A Prospective Study and Literature Review
Author Notes
  • From the Department of Obstetrics and Gynecology at the New York University Langone Hospital-Brooklyn (Drs Martingano, Rogoff, and Aglialoro); the A.T. Still University School of Osteopathic Medicine in Arizona in Mesa (Drs Ho and Chang); the Department of Obstetrics and Gynecology at Maimonides Medical Center in Brooklyn, New York (Dr Rogoff); the Department of Obstetrics and Gynecology at New York University School of Medicine (Dr Martingano); and the Department of Biomedical Informatics at Rutgers University School of Health Professions in Newark, New Jersey (Dr Martingano). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Daniel Martingano, DO, PhD, Saint John's Episcopal Hospital, 327 Beach 19th St, Far Rockaway, NY 11691-4423. Email: danielmartinganodo@gmail.com
     
Article Information
Obstetrics and Gynecology
Brief Report   |   June 2019
Effect of Osteopathic Obstetrical Management on the Duration of Labor in the Inpatient Setting: A Prospective Study and Literature Review
The Journal of the American Osteopathic Association, June 2019, Vol. 119, 371-378. doi:10.7556/jaoa.2019.066
The Journal of the American Osteopathic Association, June 2019, Vol. 119, 371-378. doi:10.7556/jaoa.2019.066
Abstract

Context: Several studies have investigated the effects of osteopathic manipulative treatment (OMT) on labor duration, but the outcomes remain ambiguous. Confounding the relationship between OMT and labor duration is the lack of standardization between treatment settings, gestational ages at the time of treatment, OMT techniques, and overall obstetrical management principles from foundational and modern osteopathic approaches.

Objective: To evaluate the effect of OMT on labor duration when applied in tandem with standard obstetrical management in the inpatient setting.

Methods: This pilot prospective observational study was conducted from June 2017 through September 2017. All patients who received OMT as part of their labor management were included. These patients were matched with controls who did not receive OMT. The OMT protocol involved once-daily administration of suboccipital decompression, thoracic inlet release, rib raising, paraspinal inhibition, and sacral inhibition. Obstetrical decisions regarding labor management were made by 1 senior attending osteopathic obstetrician. Labor management as well as OMT was carried out by osteopathic obstetricians in the OMT group, whereas allopathic obstetricians carried out labor management in the control group.

Results: A total of 100 patients were enrolled. Fifty patients who underwent adjunctive OMT in addition to standard labor management were matched to controls who received standard labor management only. Each group was represented by an ethnically diverse population. The mean (SD) labor duration for patients receiving OMT was significantly shorter than the labor duration for controls (11.34 [6.62] hours [range, 1.1-27.0 hours] vs 16.57 [4.39] [range, 1.0-58.8 hours], respectively; P=.03). All other measures studied did not achieve statistical significance.

Conclusion: Pregnancy and labor present many musculoskeletal and neurovisceral challenges to obstetrical patients and, to the authors’ knowledge, this is the first study to present an effective, efficient, and feasible approach to intrapartum osteopathic obstetrical management in the inpatient setting to reduce labor duration.

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