الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Although severe pain is not life-threatening in healthy parturient women, it can have neuropsychological consequences. Postnatal depression may be more common when analgesia is not used, and pain during labour has been correlated with the development of post-traumatic stress disorder. Labour may be the most painful experience many women ever encounter. The experience is different for each woman, and the different methods chosen to relieve pain depend upon the techniques available locally and the personal choice of the individual. Transcutaneous electrical nerve stimulation (TENS) is the transmission of low-voltage electrical impulses from a handheld battery-powered generator to the skin via surface electrodes. Long used in much of the world for control of chronic or postsurgical pain as an adjunct to or replacement for pain medication, TENS was introduced into maternity care in Scandinavia in the 1970s. Today it is widely used and rated highly by users in the United Kingdom, Scandinavia, parts of Canada, and in other countries. In fact, TENS units, designed for convenient use by the woman in labour. Pethidine is a synthetic phenylpiperidine derivative which is commonly administered intramuscularly at a dose of 1 mg/kg. Pethidine, like other opioids, delays gastric emptying and has been shown to increase gastric volumes in labour. It also causes sedation, dose-dependent respiratory depression. It crosses the placenta, and its effects on the fetus are dependent on dose and timing of administration. This study was conducted in at Banha University and Berket El-Sabaa Hospital. It included 200 pregnant women who were in spontaneous labour. Selection of cases was according to inclusion and exclusion criteria. The inclusion criteria will be as follow: 1- Female parturients aged between 18-35 years 2- Uncomplicated singleton and term (37-40week) pregnancy 3- In active labour (defined as the presence of at least three regular painful uterine contractions over 10 min with cervical dilatation 4cm) 4- Vertex presentation (occipto-anterior) and expectancy for a non-complicated vaginal delivery 5- Patients who desire labour analgesia 6- Absence of maternal medical disorder such as cardiologic, respiratory, hepatic or neurological disorder. Exclusion criteria: 1-Cervical dilatation >4cm 2- Cephalo pelvic disproportion 3-Uteroplacental insufficiency 4- Pace maker application. 5- Allergy to pethidine. 6- IUFD or any congenital fetal malformations. 7- Use of analgesia prior to randomization 8- Multiple pregnancies For the evaluation of pain intensity during labour in both groups, the present study used the visual analogue scale (VAS) as this is the most simple and indeed reliable form of pain measurement. The women were asked to mark the 10 cm line at the point which represented their ‘pain intensity during the last contractions’. The marking took place between and not during the contractions. Conclusion In this study women applying TENS reported pain in labour less than pethidine groups, however the difference was statistically insignificant. In this study TENS seems to have impact on decreasing the duration of first stage of labour. As regards the use of “oxytocin” there was more significant use of oxytocin in the pethidine group. TENS showed no impact on mode of delivery compared to Pethidine. The present study showed that TENS is not associated with harm to neonates. Majority of women in the TENS group were more satisfied with pain relief compared with women in pethidine group. Most women in the TENS group expressed desire to use TENS again. TENS can be used as a good alternative to pethidine during labour with out side effects on mothers or newborns.