Enema versus No-Enema in Pregnant Women on Admission in Labor: A Randomized Controlled Trial
Ekachai Kovavisarach MD*, Wirawan Sringamvong MD*
Affiliation : * Department of Obstetrics and Gynecology, Rajavithi Hospital
Objective : To compare the maternal and neonatal outcomes between enema and no-enema in pregnant women
on admission in labor
Materials and Methods : One thousand and one hundred term pregnant women with labor pain were selected
randomly on admission to be assigned into two groups at Rajavithi Hospital from 1 February 2002 to 15 June
2002. Five -hundred and thirty-nine cases received enema and five-hundred and sixty one cases received no-
enema. Seventy three women (39 and 34 cases from the enema and no-enema groups, respectively) were
excluded because of cesarean section due to obstetric indications. Five hundred cases received enema and
five -hundred and twenty -seven cases received no-enema. All cases were delivered vaginally.
Results : There was no statistical significant difference between the two groups with regards to maternal age,
gestational age, gravidity, parity, mode of delivery, type of episiotomy and degree of perineal tear. Fecal
contamination rate during the second stage of labor was significantly higher in the women who received
no-enema (34.9%) in comparision with those receiving enema (22.8% (p < 0.001). No neonatal infection
occurred in both groups. Duration of labor was significantly longer in the women who received no-enema
(459.8 min) compared with those who received enema (409.4 min) (p < 0.001).
Conclusion : No-enema methods on admission in labor had significantly more increase in fecal contamination
in the second stage of labor and longer duration of labor than the enema method. But there was no difference
in perineal wound infection and neonatal infection between both groups.
Keywords : Fecal contamination, Duration of labor, Perineal wound infection, Neonatal infection, Enema, No enema
