Early pushing urge before full dilation : a scoping review Tsao, Nancy
This scoping review attempts to collect and catalog the relevant studies and literatures on the incidence, risks, and management methods of the early pushing urge before full dilation. Literatures relevant to the early pushing urge were electronically searched in 15 online databases and hand-searched with citation searches. A total of 26 eligible literatures were identified. The only peer-reviewed research studies identified included one randomized controlled trial, one prospective observational study, and four case reports. Evidence on the early pushing urge was generally lacking. The best-estimated incidence rate of the early pushing urge was 7.6%. Pushing with the early urge before full dilation did not seem to increase the risk of cervical edema or any other adverse maternal or neonatal outcomes. Evidence on the optimum management of the early pushing urge was limited. Most experts recommended an individualized management plan, which would allow a woman to push with the early urge as long as certain maternal and fetal conditions are satisfied. Some evidence suggested the early pushing urge may resolve spontaneously without interventions. Further investigations on the optimum management methods, effectiveness of various active management options, women’s experience of the early pushing urge and its management are recommended.
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