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Labour analgesia

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https://www.readbyqxmd.com/read/28263154/-asymptomatic-spontaneous-rupture-of-the-uterus-without-previous-sectio
#1
Stine Kretzschmar Nielsen, Lars Høj
Rupture of the uterus is rare but catastrophic. Rupture often results in fetal bradycardia, abdominal pain, haemodynamic changes and vaginal bleeding. A 36-year-old healthy woman, gravida 3, para 1, went into spontaneous labour at gestation age 39 + 4, and at orificium 7 cm she received epidural analgesia. Following the epidural, the fetal heartbeat could not be registered by external cardiotocography, and caput could not be palpated. Spontaneous birth was attempted, but a caesarean section was necessary. The baby was found in the abdomen...
February 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28250488/barriers-for-labour-analgesia-in-south-india-knowledge-and-attitude-of-relevant-stakeholders-a-hospital-based-cross-sectional-study
#2
S Syed Thahir Hussain, P Maheswari
No abstract text is available yet for this article.
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28238320/-oxytocin-administration-during-spontaneous-labour-guidelines-for-clinical-practice-guidelines-short-text
#3
C Dupont, M Carayol, C Le Ray, C Barasinski, R Beranger, A Burguet, A Chantry, C Chiesa, B Coulm, A Evrard, C Fischer, L Gaucher, C Guillou, F Leroy, E Phan, A Rousseau, V Tessier, F Vendittelli, C Deneux-Tharaux, D Riethmuller
OBJECTIVES: To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. METHOD: A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. RESULTS: The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5cm of cervical dilatation...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#4
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#5
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28157275/continuous-cardiotocography-ctg-as-a-form-of-electronic-fetal-monitoring-efm-for-fetal-assessment-during-labour
#6
REVIEW
Zarko Alfirevic, Declan Devane, Gillian Ml Gyte, Anna Cuthbert
BACKGROUND: Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. OBJECTIVES: To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28102539/determination-of-the-median-effective-dose-ed50-of-spinal-chloroprocaine-in-labour-analgesia
#7
M Coppens, S Anssens, A Parashchanka, K Roelens, E Deschepper, S De Hert, P F Wouters
The primary goal of this study was to determine the median effective dose (ED50 ) of spinal chloroprocaine for labour analgesia. Thirty-eight parturients requesting neuraxial analgesia were enrolled. Doses of 1% chloroprocaine were determined by the technique of up-down sequential allocation, with an initial dose of 20 mg and steps of 2 mg. The chloroprocaine spinal dose was given as the spinal component of a combined spinal-epidural, which was then supplemented with an epidural dose of 7.5 μg sufentanil in 7 ml saline...
January 19, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28089318/analysis-and-evaluation-of-the-effectiveness-of-epidural-analgesia-and-its-relationship-with-eutocic-or-dystocic-delivery
#8
V Sánchez-Migallón, E Sánchez, M Raynard, A Miranda, R M Borràs
OBJECTIVE: Numerous studies have demonstrated the difference in the verbal rating scale with regard to obstructed labour and induced labour, so that obstructed labour and foetal macrosomia have been related to a greater sensation of pain during labour, particularly in the first stage. Even the epidural analgesia is linked to the need for instrumented or caesarean section due to foetal obstruction. The goal of the study is to analyze and evaluate the effectiveness of epidural analgesia in normal versus obstructed labour...
January 12, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28075507/labour-induction-near-term-for-women-aged-35-or-over-an-economic-evaluation
#9
Kate F Walker, Melina Dritsaki, George Bugg, Marion Macpherson, Carol McCormick, Nicky Grace, Chris Wildsmith, Lucy Bradshaw, Gordon Cs Smith, James G Thornton
OBJECTIVE: Induction of labour at 39 weeks for nulliparous women aged 35 years and over may prevent stillbirths and does not increase caesarean births, so it may be popular. But the overall costs and benefits of such a policy have not been compared. DESIGN: A cost-utility analysis alongside a randomised controlled trial (the 35/39 trial). SETTING: Obstetric departments of 38 UK National Health Service hospitals and one UK primary care trust...
January 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28068929/are-freestanding-midwifery-units-a-safe-alternative-to-obstetric-units-for-low-risk-primiparous-childbirth-an-analysis-of-effect-differences-by-parity-in-a-matched-cohort-study
#10
Louise Fischer Christensen, Charlotte Overgaard
BACKGROUND: Intrapartum complications and the use of obstetric interventions are more common in primiparous childbirth than in multiparous childbirth, leading to concern about out of hospital birth for primiparous women. The purpose of this study was to determine whether the effect of birthplace on perinatal and maternal morbidity and the use of obstetric interventions differed by parity among low-risk women intending to give birth in a freestanding midwifery unit or in an obstetric unit in the North Denmark Region...
January 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#11
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28049522/paradox-of-the-institution-findings-from-a-hospital-labour-ward-ethnography
#12
Elizabeth C Newnham, Lois V McKellar, Jan I Pincombe
BACKGROUND: Interest in the influence of culture on birth practices is on the rise, and with it comes a sense of urgency to implement practices that aid the normalisation and humanisation of birth. This groundswell is occurring despite a broader cultural milieu of escalating technology-use and medicalisation of birth across the globe. Against this background, rates of epidural analgesia use by women in labour are increasing, despite the risk of side effects. Socio-cultural norms and beliefs are likely to influence pain relief choices but there is currently scant research on this topic...
January 3, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27990163/the-effect-of-epidural-analgesia-on-the-delivery-outcome-of-induced-labour-a-retrospective-case-series
#13
Angeliki Antonakou, Dimitrios Papoutsis
Objective. To investigate whether the use of epidural analgesia during induced labour was a risk factor for instrumental vaginal delivery and caesarean section (CS) delivery. Study Design. This was a retrospective case series of primigravidae women being induced at term for all indications with a normal body mass index (BMI) at booking and under the age of 40 years. Results. We identified 1,046 women who fulfilled the inclusion criteria of which 31.2% had an epidural analgesia. Those with an epidural analgesia had significantly greater maternal age, higher BMI, greater percentage of oxytocin usage, and a longer first and second stage of labour...
2016: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/27986648/associations-between-maternal-characteristics-and-women-s-responses-to-acupuncture-during-labour-a-secondary-analysis-from-a-randomised-controlled-trial
#14
Linda Vixner, Erica Schytt, Lena B Mårtensson
BACKGROUND: Patient characteristics are modulators of pain experience after acupuncture treatment for chronic pain. Whether this also applies to labour pain is unknown. AIM: To examine for associations between maternal characteristics and response to acupuncture in terms of labour pain intensity in close proximity to the treatment (within 60 min) and over a longer time period (up to 240 min), and whether or not epidural analgesia is used, before and after adjustment for obstetric status upon admission to the labour ward...
December 16, 2016: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/27955688/the-respite-trial-remifentanil-intravenously-administered-patient-controlled-analgesia-pca-versus-pethidine-intramuscular-injection-for-pain-relief-in-labour-study-protocol-for-a-randomised-controlled-trial
#15
Matthew Wilson, Christine MacArthur, Fang Gao Smith, Leanne Homer, Kelly Handley, Jane Daniels
BACKGROUND: The commonest opioid used for pain relief in labour is pethidine (meperidine); however, its effectiveness has long been challenged and the drug has known side effects including maternal sedation, nausea and potential transfer across the placenta to the foetus. Over a third of women receiving pethidine require an epidural due to inadequate pain relief. Epidural analgesia increases the risk of an instrumental vaginal delivery and its associated effects. Therefore, there is a clear need for a safe, effective, alternative analgesic to pethidine...
December 12, 2016: Trials
https://www.readbyqxmd.com/read/27918616/nitric-oxide-donors-for-cervical-ripening-and-induction-of-labour
#16
REVIEW
Arpita Ghosh, Katherine R Lattey, Anthony J Kelly
BACKGROUND: Sometimes it is necessary to bring on labour artificially because of safety concerns for the mother or baby. This review is one of a series of reviews of methods of labour induction using a standardised protocol. OBJECTIVES: To determine the effects of NO donors (isosorbide mononitrate (ISMN), isosorbide dinitrate (ISDN), nitroglycerin and sodium nitroprusside) for third trimester cervical ripening or induction of labour, in comparison with placebo or no treatment or other treatments from a predefined hierarchy...
December 5, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27855515/influence-of-obstetrical-events-on-satisfaction-and-anxiety-during-childbirth-a-prospective-longitudinal-study
#17
Lucia Floris, Olivier Irion, Delphine Courvoisier
The aim of this study was to investigate the feelings of anxiety and satisfaction among 79 primiparas who had uncomplicated pregnancies, at the time of hospital admission and after birth, considering the mode of delivery, analgesia, and pain levels. Questionnaires were completed at admission to the hospital and two months after delivery, using the State-Trait Anxiety Inventory (STAI) state scale and the Labour Agentry Scale. The mean (SD) STAI state score was higher at admission (36.7 (10.7)) than 4 months after childbirth (32...
November 17, 2016: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/27849306/eisenmenger-syndrome-in-pregnancy
#18
Shi-Min Yuan
Eisenmenger syndrome is very rare in pregnant women. Debates remain concerning the management of Eisenmenger syndrome in this patient population and the prognosis is unclear in terms of maternal and fetoneonatal outcomes. Epidural analgesia is preferred for Cesarean section as it alleviates perioperative pain and reduces the pulmonary and systemic vascular resistances. Maternal mortality in the presence of Eisenmenger syndrome is reported as 30-50% and even up to 65% in those with Cesarean section. The major causes of death could be hypovolemia, thromboembolism and preeclampsia...
July 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27821464/safety-of-labour-and-delivery-following-closures-of-obstetric-services-in-small-community-hospitals
#19
Jennifer A Hutcheon, Corinne A Riddell, Erin C Strumpf, Lily Lee, Sam Harper
BACKGROUND: In recent decades, many smaller hospitals in British Columbia, Canada, have stopped providing planned obstetric services. We examined the effect of these service closures on the labour and delivery outcomes of pregnant women living in affected communities. METHODS: We used maternal postal codes to identify delivery records (1998-2014) of women residing in a community affected by service closure. The records were obtained from the British Columbia Perinatal Data Registry...
November 7, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27816738/epidural-analgesia-during-labour-routinely-or-on-request-a-cost-effectiveness-analysis
#20
Kimberley Bonouvrié, Anouk van den Bosch, Frans J M E Roumen, Sander M van Kuijk, Jan G Nijhuis, Silvia M A A Evers, Martine M L H Wassen
OBJECTIVE: To assess the cost-effectiveness of routine labour epidural analgesia (EA), from a societal perspective, as compared with labour analgesia on request. STUDY DESIGN: Women delivering of a singleton in cephalic presentation beyond 36+0 weeks' gestation were randomly allocated to routine labour EA or analgesia on request in one university and one non-university teaching hospital in the Netherlands. Costs included all medical, non-medical and indirect costs from randomisation to 6 weeks postpartum...
December 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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