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Labor epidural

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https://www.readbyqxmd.com/read/29153691/hypertension-and-patterns-of-induced-labor-at-term
#1
Julia M Bregand-White, Michelle A Kominiarek, Judith U Hibbard
OBJECTIVE: To study patterns of induced labor at term in hypertensive women. STUDY DESIGN: We performed a retrospective cohort study using the Consortium on Safe Labor database; a multicenter study of labor and delivery practices from electronic medical records in 19 hospitals. 55,572 women were studied: 28,254 nulliparas and 27,318 multiparas, undergoing induction of labor at term without a prior cesarean with a singleton vertex live born fetus. Four hypertensive groups were defined: chronic hypertension (n=1164), gestational hypertension (n=1861), preeclampsia (n=1513) and superimposed preeclampsia (n=655), compared to controls (no hypertension, n=50,379)...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29141373/-a-concentration-response-observation-of-hydromorphone-combined-with-ropivacaine-in-labor-analgesia
#2
Y Y Lu, H Huang, W L Mao, R H Liu, M J Hu, L X Shao, M P Hu, J Li
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29123430/the-use-of-invos%C3%A2-somatic-oximetry-to-measure-variations-in-placental-tissue-oxygenation-in-laboring-healthy-term-parturients-with-epidural-analgesia-an-observational-study
#3
Christian Loubert, Mélissa Ouellette, Valérie Zaphiratos, Issam Tanoubi
Purpose: Near-infrared spectroscopy provides a non-invasive continuous real-time monitoring of tissue oxygen saturation. As uterine contractions during labor may be associated with a transient uteroplacental hypoperfusion, this prospective, observational study investigates the ability of near-infrared spectroscopy to detect variation in uteroplacental oximetry during uterine contractions. Patients and methods: Four Invos™ oximetry probes (Medtronic(®), Minneapolis, MN, USA) per subjects were applied on the placental surface (PLA), the abdomen (MYO), the forearm (ARM) and the leg (LEG), of twenty healthy laboring parturients with epidural analgesia...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29112650/maternal-pulse-pressure-and-the-risk-of-postepidural-complications-a-randomized-controlled-trial
#4
Justin R Lappen, Stephen A Myers, Norman Bolen, Brian M Mercer, Edward K S Chien
OBJECTIVE: To test the hypothesis that increasing the intravenous fluid bolus volume at the time of epidural placement in women with narrow pulse pressure would reduce postepidural fetal heart rate (FHR) abnormalities, hypotension, and resuscitative obstetric interventions. METHODS: We performed a single-center randomized controlled trial. Eligible participants were normotensive with a nonanomalous singleton gestation at or after 35 weeks and with a narrow pulse pressure (less than 45 mm Hg) on admission...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29099021/a-prospective-randomized-trial-of-postural-changes-vs-passive-supine-lying-during-the-second-stage-of-labor-under-epidural-analgesia
#5
María Simarro, José Angel Espinosa, Cecilia Salinas, Ricardo Ojea, Paloma Salvadores, Carolina Walker, José Schneider
There exist very few studies comparing different postures or postural changes during labor in parturients with epidural analgesia. AIM: To disclose whether the intervention of a multidisciplinary nursing team including a physiotherapist during the second stage of labor improves the obstetric outcome in parturients with epidural analgesia. DESIGN: Prospective randomized trial. SETTING: University-affiliated hospital. POPULATION: Women undergoing labor with epidural analgesia after a normal gestation...
March 8, 2017: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29096283/positions-during-the-first-stage-and-the-passive-second-stage-of-labor-a-survey-of-french-midwives
#6
Chloé Barasinski, Anne Debost-Legrand, Didier Lémery, Françoise Vendittelli
OBJECTIVE: the objective of our study was to describe the practices reported by French midwives during labor (first stage and passive phase of the second stage). DESIGN: this cross-sectional internet questionnaire surveyed French midwives who attended at least one delivery in 2013. SETTING: this open survey was posted on a website from June 15 through December 1, 2014. PARTICIPANTS: 1496 midwives from 377 maternity units participated in the study...
October 17, 2017: Midwifery
https://www.readbyqxmd.com/read/29094374/birth-plans-impact-on-mode-of-delivery-obstetrical-interventions-and-birth-experience-satisfaction-a-prospective-cohort-study
#7
Yalda Afshar, Jenny Y Mei, Kimberly D Gregory, Sarah J Kilpatrick, Tania F Esakoff
OBJECTIVE: To examine whether the presence of a birth plan was associated with mode of delivery, obstetrical interventions, and patient satisfaction. METHODS: This was a prospective cohort study of singleton pregnancies greater than 34 weeks' gestation powered to evaluate a difference in mode of delivery. Maternal characteristics, antenatal factors, neonatal characteristics, and patient satisfaction measures were compared between groups. Differences between groups were analyzed using chi-squared for categorical variables, Fisher exact test for dichotomous variables, and Wilcoxon rank sum test for continuous or ordinal variables...
November 2, 2017: Birth
https://www.readbyqxmd.com/read/29080696/women-s-experiences-with-immediate-postpartum-intrauterine-device-insertion-a-mixed-methods-study
#8
Shannon L Carr, Rameet H Singh, Andrew L Sussman, Rebecca G Rogers, Brenda Pereda, Eve Espey
OBJECTIVE: To describe women's pain and experiences with immediate postpartum intrauterine device (IUD) insertion (IPPI) following vaginal delivery using a ring forceps insertion technique. STUDY DESIGN: This observational mixed methods study included women who underwent successful IPPI using ring forceps, with and without epidural analgesia. To describe women's pain during the procedure, we recruited women during antenatal care and at the time of admission for delivery until we collected at least 30 sets of pain scores at two time points (pre-procedure and immediately post-procedure) in both groups using two instruments; 100mm visual analogue scale (VAS) and a 4-point Likert verbal rating scale (VRS) (0=none, 1=mild, 2=moderate, 3=severe)...
October 25, 2017: Contraception
https://www.readbyqxmd.com/read/29078938/defining-and-managing-normal-and-abnormal-second-stage-of-labor
#9
REVIEW
Yvonne W Cheng, Aaron B Caughey
The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 49 on Dystocia and Augmentation of Labor defines a prolonged second stage as more than 2 hours without or 3 hours with epidural analgesia in nulliparous women, and 1 hour without, or 2 hours with epidural in multiparous women. This definition diagnoses 10% to 14% of nulliparous and 3% to 3.5% of multiparous women as having a prolonged second stage. Although current labor norms remained largely based on data established by Friedman in the 1950s, modern obstetric population and practice have evolved with time...
December 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29077661/is-low-concentration-2-chloroprocaine-for-epidural-labor-analgesia-a-better-option
#10
John C Coffman, Kristin I Brower, Robert H Small
No abstract text is available yet for this article.
October 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29073508/lower-limbs-venous-compression-reduces-the-incidence-of-maternal-hypotension-following-epidural-analgesia-during-term-labor
#11
Violaine Peyronnet, Arnaud Roses, Aude Girault, Marie Pierre Bonnet, Francois Goffinet, Vassilis Tsatsaris, Edouard Lecarpentier
OBJECTIVE(S): Every year in France, 10% to 20% of the 600 000 women given epidural analgesia during labor experience hypotension, which in 15% of cases is associated with fetal heart rate abnormalities. The efficiency of lower limbs venous compression in preventing the occurrence of maternal hypotension after neuraxial anesthesia has already been demonstrated, but only in the context of scheduled cesarean section. We assessed the preventive effect of medical lower limbs venous compression on the incidence of maternal hypotension after epidural analgesia during spontaneous term labor...
October 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29072177/effects-of-intradermal-sterile-water-injections-in-women-with-low-back-pain-in-labor-a-randomized-controlled-clinical-trial
#12
Refika Genç Koyucu, Nurdan Demirci, Ayşe Ender Yumru, Süleyman Salman, Yavuz Tahsin Ayanoğlu, Yıldız Tosun, Cihangir Tayfur
BACKGROUND: In addition to pain caused by uterine contractions in labor, continuous and severe back pain is observed in 33% of women. Several pharmacological and nonpharmacological methods are available for managing this pain. Sterile water injection is considered to be an alternative method for nonpharmacological management. AIM: The aim of this study was to assess the satisfaction level and effectiveness of sterile water injection for back pain among women in labor...
October 26, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/29064530/epiduralkateter-med-knut-%C3%A3-r-en-ovanlig-komplikation-alltf%C3%A3-r-l%C3%A3-ng-inmatning-%C3%A3-kar-risken-%C3%A2-4%C3%A2-5-cm-rekommenderas
#13
Lovisa Baer Eriksson, Anna Borglund-Hemph, Jan Jakobsson
Knot on the epidural catheter, a rare complication: a case report A 30-year 1-grava woman received an epidural for labor pain. Insertion was uncomplicated and she had an effective analgesia. The epidural was successfully converted to epidural anaesthesia for Caesarean section. The epidural was removed 24 hours thereafter. The mother was lying and trying to curve the back during removal. It was initially easy to pull but after some centimeters it became difficult. The mother was asked to curve further and pulling continued...
October 23, 2017: Läkartidningen
https://www.readbyqxmd.com/read/29049070/noninfectious-fever-in-the-near-term-pregnant-rat-induces-fetal-brain-inflammation-a-model-for-the-consequences-of-epidural-associated-maternal-fever
#14
Scott Segal, Carlo Pancaro, Iwona Bonney, James E Marchand
BACKGROUND: Women laboring with epidural analgesia experience fever much more frequently than do women who chose other forms of analgesia, and maternal intrapartum fever is associated with numerous adverse consequences, including brain injury in the fetus. We developed a model of noninfectious inflammatory fever in the near-term pregnant rat to simulate the pathophysiology of epidural-associated fever and hypothesized that it would produce fetal brain inflammation. METHODS: Twenty-four pregnant Sprague-Dawley rats were studied at 20 days gestation (term: 22 days)...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29016499/epidural-analgesia-during-the-second-stage-of-labor-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
XiaoFeng Shen, Yunping Li, ShiQin Xu, Nan Wang, Sheng Fan, Xiang Qin, Chunxiu Zhou, Philip E Hess
OBJECTIVE: To evaluate whether maintaining a motor-sparing epidural analgesia infusion affects the duration of the second stage of labor in nulliparous parturients compared with a placebo control. METHODS: We conducted a double-blind, randomized, placebo-controlled trial involving nulliparous women with term cephalic singleton pregnancies who requested epidural analgesia. All women received epidural analgesia for the first stage of labor using 0.08% ropivacaine with 0...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28991063/dose-response-curves-for-intrathecal-bupivacaine-levobupivacaine-and-ropivacaine-given-for-labor-analgesia-in-nulliparous-women
#16
Warwick D Ngan Kee, Floria F Ng, Kim S Khaw, Shannon P Y Tang, Alison G P Koo
BACKGROUND AND OBJECTIVES: Bupivacaine, levobupivacaine, and ropivacaine are often given intrathecally for labor analgesia, but limited data are available for their dose-response properties in this context. The objective of this study was to describe the dose-response curves of these local anesthetics when given intrathecally for labor analgesia, to determine values for D50 (dose producing a 50% response) and to compare the calculated values of D50 for levobupivacaine and ropivacaine with those for bupivacaine...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28985581/postpartum-tubal-ligation-a-retrospective-review-of-anesthetic-management-at-a-single-institution-and-a-practice-survey-of-academic-institutions
#17
Christine McKenzie, Seden Akdagli, Gillian Abir, Brendan Carvalho
STUDY OBJECTIVE: The primary aim was to evaluate institutional anesthetic techniques utilized for postpartum tubal ligation (PPTL). Secondarily, academic institutions were surveyed on their clinical practice for PPTL. DESIGN: An institutional-specific retrospective review of patients with ICD-9 procedure codes for PPTL over a 2-year period was conducted. Obstetric anesthesia fellowship directors were surveyed on anesthetic management of PPTL. SETTING: Labor and delivery unit...
October 3, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28941065/an-economic-model-of-professional-doula-support-in-labor-in-british-columbia-canada
#18
Gillian E Hanley, Lily Lee
INTRODUCTION: Spending on care in childbirth represents a sizable portion of health care budgets. This has engendered a growing interest in potential clinical tools that could be used to improve patient experience and population health at a lower cost. A possible such tool is continuous support in labor from a trained doula, as doula care can decrease the likelihood of cesarean birth, epidural analgesia, and assisted vaginal birth. In addition, there is some emerging evidence suggesting that involving doulas in prenatal care can reduce rates of preterm birth...
September 20, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#19
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28930940/the-relationship-between-women-s-intention-to-request-a-labor-epidural-analgesia-actually-delivering-with-labor-epidural-analgesia-and-postpartum-depression-at-6-weeks-a-prospective-observational-study
#20
Sharon Orbach-Zinger, Ruth Landau, Avi Ben Harousch, Oren Ovad, Liron Caspi, Evgeniya Kornilov, Alexander Ioscovich, Danielle Bracco, Atara Davis, Shlomo Fireman, Moshe Hoshen, Leonid A Eidelman
BACKGROUND: Postpartum depression (PPD) is associated with pain during and after delivery, with studies showing reduced rates among women delivering with labor epidural analgesia (LEA). We hypothesized that women who intend to deliver with LEA but do not receive it are at higher risk for PPD at 6 weeks due to the combined experience of untreated labor pain and unmatched expectations during labor, and evaluated the interaction between labor plans related to LEA, satisfaction with pain control when actually delivering with LEA, and PPD at 6 weeks after delivery...
September 19, 2017: Anesthesia and Analgesia
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