By Interactive Metronome - April 26, 2013

Concentration and the Second Stage of Labor: Outcomes Associated with the Interactive Metronome


This is a very interesting study that demonstrates use of the Interactive Metronome (IM) as an evidence-based diagnostic tool.  Interactive Metronome is the only technology that can objectively measure millisecond timing in the brain that has been directly associated with attention, concentration and motor synchronization in published studies too numerous to count.  Researchers from Northwestern University’s Feinberg School of Medicine Department of Obstetrics and Gynecology utilized IM as a measure of attention & concentration.  With a sample size of 138 women in the 34th week of gestation who planned to receive an epidural during delivery, this study was conducted over a 1 year period. 

Receiving an epidural to reduce pain during child labor has been associated with a reduction in the urge to push in the second stage, and several studies have shown receiving an epidural lengthens this stage of labor in women who have never previously given birth (nulliparous women).  A further consequence of prolonged labor in the second stage is cesarean delivery.  In this study, Interactive Metronome was used to measure the mother’s ability to concentrate and synchronize motor activity.  According to the authors, “We hypothesized that nulliparous women who have scores [measured by Interactive Metronome] that are indicative of better concentration skills and ability to synchronize motor activity would also have shorter second stages of labor.” 

Women who achieved a score of  >91.9 milliseconds on IM assessment had the poorest concentration and motor synchronization.  Significantly, they also had prolonged labor in the second stage as compared to women who achieved lower millisecond scores and demonstrated better concentration and motor synchronization.  

The authors concluded, “This finding raises the possibility that education directed toward improving the scores and the synchronization of motor control also may lessen the length of the second stage and, ultimately, the chance of an operative intervention. The present study was not designed to demonstrate that improvement in scores after training with the Interactive Metronome would shorten the length of the second stage. Such an association, if found, could give support to the concept that this capacity is a modifiable factor, and a trial in which women were randomized either to receive or not receive education and training with this tool could help to determine whether it is beneficial.”

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