a comparative study on the effects of transcutaneous electrical nerve stimulation at acupoints on the progress and duration of labor in nulliparous women

Background: fear and anxiety during labor are common among nulliparous women and may contribute to prolonged labor stages. transcutaneous electrical nerve stimulation (tens) is known for its anxiolytic effects, acting through the activation of inhibitory pathways in the central nervous system. this study aims to compare the effects of tens at the hugo and sanyinjiao acupressure points on labor progression and duration in nulliparous women.methods: this randomized clinical trial involved 123 nulliparous women referring to an educational-therapeutic center in zanjan city, iran. the participants were randomly assigned to three groups of 41 each: the hugo group, the sanyinjiao group, and the control group. the intervention began when cervical dilation reached 4 cm and labor pains started, and continued through the active phase of the first and second stages of labor. tens was applied at acupressure points according to group allocation. labor duration and clinical assessments were recorded using a standardized labor progress checklist. statistical analyses were conducted using r software, version 4.2.2, employing analysis of variance (anova) or the kruskal-wallis test, with dunn correction applied for multiple comparisons. a p<0.05 was considered statistically significant.results: the mean duration of the first stage of labor significantly differed among the groups (p=0.002), with the hugo group showing an average of five hours (interquartile range [iqr]: 4.75–6) compared to 6 hours (iqr: 5–7) in the sanyinjiao and control groups. the second stage of labor also showed a significant difference in duration (p<0.001), with a mean duration of 15 min (iqr: 10–16.25) in the hugo group, 37.5 min (iqr: 30–60) in the sanyinjiao group, and 30 min (iqr: 20–60) in the control group.conclusion: the application of tens at specific acupressure points, such as hugo’s point, can effectively reduce labor duration. however, the findings revealed that the second stage of labor was longer in the sanyinjiao group compared to the control group, which may be related to a different physiological response at this point or the method of intervention, warranting further studies in the future.