New trial examines effect of sterile water injections on caesarean rates

New trial examines effect of sterile water injections on caesarean rates

Women birthing at Mater Mothers' Hospital can now be involved in a research study examining the impact of sterile water injections on reducing pain and lowering caesarian rates.

For the one-in-three women who experience severe back pain during labour and birth, a new trial of sterile water injections at Mater Mothers’ Hospital (MMH) presents new hope for less invasive pain relief and a natural birth.

While sterile water injections (SWI) of the lower back have been used in midwifery practice at Mater since February 2009, the new ‘Impact on Caesarean Section Rates following Injections of Sterile Water’ (ICARIS) trial will examine if the injections can lead to a reduction in caesarean section numbers.

Professor of Midwifery Dr Sue Kildea said the advantages of SWI during labour include that it often has an immediate effect of pain relief; has no effect on mother’s state of consciousness and no effect on baby and it does not limit a mother’s mobility or adversely affect the labour progress.

“It is also a simple procedure that can be administered by a midwife and repeated as needed,” Prof Kildea said.

But there may be added benefits, with previous studies suggesting women who received the SWI were less likely to require a caesarean section.

“It is not clear if this is because they received injection or because of other influences in the labour process but we hope that a large study, such as the ICARIS trial, will help to answer this question,” Prof Kildea said.

“There is also limited information about analgesic and epidural anaesthesia use following sterile water injections in labour and the ICARIS trial will aid in filling these knowledge gaps.”

The randomised, controlled trial of four intradermal sterile water injections versus a placebo will run for two years and include participants birthing at Mater Mothers’ Hospital, Royal Brisbane and Women’s Hospital, Ipswich Hospital, Townsville Hospital, Nambour Hospital and the Royal Hospital for Women (Sydney).

Rockhampton Hospital, The Flinders Medical Centre, Lyell McEwin Hospital and the Women and Children’s Hospital (Adelaide) have agreed in principle to also participate.

“Once women have presented to their birth suite in labour and are experiencing back pain and requesting analgesia, their midwife will invite them to participate in the trial,” Prof Kildea said.

The ICARIS trial is being conducted by the Midwifery Research Unit, a collaboration between Mater Research and Australian Catholic University, and has been funded by the National Health and Medical Research Council.

The study has been approved by the Royal Brisbane and Women’s Hospital Human Research Ethics Committee and the Australian Catholic University Human Research Ethics Committee.

For more information on the ICARIS trial, please contact 07 3163 6313 or email icaris@mater.org.au.

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