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Labor epidural

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https://www.readbyqxmd.com/read/29777348/the-effect-of-labor-epidural-analgesia-on-maternal-fetal-outcomes-a-retrospective-cohort-study
#1
Qian Wang, Sheng-Xing Zheng, Yu-Fei Ni, Yuan-Yuan Lu, Bing Zhang, Qing-Quan Lian, Ming-Pin Hu
PURPOSE: To evaluate the impact of labor epidural analgesia on maternal-fetal safety outcomes in a signal Chinese academic medical center. METHODS: A single-intervention impact study was conducted at The Second Affiliated Hospital, Wenzhou Medical University. The study period was divided into three phases: (1) baseline phase: from January 1 and June 30, 2009 when no analgesic method was routinely employed during labor; (2) phase-in period: the epidural analgesia was implemented 8 a...
May 18, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29773486/labor-analgesia-in-czech-republic-and-slovakia-a-2015-national-survey
#2
J Bláha, P Štourač, M Grochová, R Klozová, S Richterová, P Nosková, D Seidlová, V Zenkner, A Novotný, D Schwarz, J Ščamburová, M Kosinová, Ch Kufa, M Kirchnerová, J Macková, L Várošová, R Toboláková, J Cepák, J Firment
BACKGROUND: The purpose of this international survey was to describe the current practices and techniques of labor analgesia in the Czech Republic (CZE) and Slovakia (SVK). METHODS: All Czech and Slovak departments that provide obstetric anesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in detail all peripartum anesthetic procedures delivered by anesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE)...
April 7, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29768964/effects-of-combined-spinal-epidural-analgesia-on-first-stage-of-labor-a-cohort-study
#3
Silvia Poma, Luigia Scudeller, Chiara Verga, Giorgio Mirabile, Barbara Gardella, Federica Broglia, Maria Ciceri, Marinella Fuardo, Simona Pellicori, Maddalena Gerletti, Silvia Zizzi, Elena Masserini, Maria Paola Delmonte, Giorgio Antonio Iotti
BACKGROUND: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on duration of stage I labor, maternal, and neonatal outcomes...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29756748/%C3%AE-opioid-receptor-genetic-polymorphisms-and-duration-of-epidural-fentanyl-analgesia-during-early-labor
#4
Nathalie K Zgheib, Marie T Aouad, Samar K Taha, Anwar H Nassar, Riwa F Masri, Mira Y Khoury, Maha H Makki, Sahar M Siddik-Sayyid
BACKGROUND: Epidural fentanyl is commonly used for initiation of early labor analgesia. The aim of this prospective study is to test the hypothesis that duration of epidural fentanyl analgesia differs in nulliparous women requesting epidural analgesia in early labor who are variant allele carriers of the OPRM1 SNVs 118A>G rs1799971, IVS2+31G>A rs9479757, and IVS2+691G>C rs2075572. METHODS: Two hundred and twenty parturients who received epidural analgesia with fentanyl were included in the 118A>G analysis, and a 196 subcohort was included in the IVS2+31G>A and IVS2+691G>C exploratory analysis...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29749657/fundal-pressure-in-second-stage-of-labor-kristeller-maneuver-is-associated-with-higher-risk-of-levator-ani-muscle-avulsion
#5
Aly Youssef, Ginevra Salsi, Ilaria Cataneo, Giuseppina Pacella, Carlotta Azzarone, Maria Chiara Paganotto, Jovana Krsmanovic, Elisa Montaguti, Luisa Cariello, Federica Bellussi, Nicola Rizzo, Gianluigi Pilu
OBJECTIVE: to investigate the association between fundal pressure in the second stage (Kristeller maneuver) and the risk of levator ani muscle (LAM) injury. METHODS: This was a prospective case-control study conducted in our university hospital. We recruited women immediately following their first vaginal delivery. Women who underwent Kristeller maneuver were recruited as cases. For each case, a control (no Kristeller) was recruited matched by BMI, epidural analgesia, second stage duration and birthweight...
May 10, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29687488/risk-factors-for-nonreassuring-fetal-heart-rate-tracings-after-artificial-rupture-of-membranes-in-spontaneous-labor
#6
Hadas Ganer Herman, Liliya Tamayev, Rotem Houli, Hadas Miremberg, Jacob Bar, Michal Kovo
BACKGROUND: We aimed to characterize factors associated with nonreassuring fetal heart (FHR) tracings after artificial rupture of membranes (AROM), during the active phase of labor. METHODS: Delivery charts of patients who presented in spontaneous labor, at term, between 2015 and 2016 were reviewed. We identified cases in which AROM was performed during the active stage of labor. We compared deliveries with a normal FHR and those who developed nonreassuring FHR...
April 24, 2018: Birth
https://www.readbyqxmd.com/read/29687477/obstetric-interventions-trends-and-drivers-of-change-a-20-year-population-based-study-from-iceland
#7
Emma M Swift, Gunnar Tomasson, Helga Gottfreðsdóttir, Kristjana Einarsdóttir, Helga Zoega
BACKGROUND: Population data on obstetric interventions is often limited to cesarean delivery. We aimed to provide a more comprehensive overview of trends in use of several common obstetric interventions over the past 2 decades. METHODS: The study was based on nationwide data from the Icelandic Medical Birth Register. Incidence of labor induction, epidural analgesia, cesarean, and instrumental delivery was calculated for all births in 1995-2014. Change over time was expressed as relative risk (RR), using Poisson regression with 95% confidence intervals (CI) adjusted for several maternal and pregnancy-related characteristics...
April 24, 2018: Birth
https://www.readbyqxmd.com/read/29686567/usefulness-of-intrapartum-magnetic-resonance-imaging-for-a-parturient-with-neurofibromatosis-type-1-during-induction-of-labor-for-preeclampsia
#8
Jacqueline M Galvan, Michael P Hofkamp
A 22-year-old woman, G3P0 at 31 weeks, 1 day gestational age, was admitted to the labor and delivery unit for induction of labor (IOL) due to preeclampsia with severe features. Her medical history included neurofibromatosis type 1 (NF-1) and systemic lupus erythematosus with pericarditis and pericardial effusion. When labor analgesia was considered, the concern for an undiagnosed spinal neurofibroma and attendant sequelae was deliberated. After a multidisciplinary discussion, the IOL was halted during the cervical ripening phase to allow timely magnetic resonance imaging (MRI) of the spine...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29683307/maternity-care-update-labor-and-delivery
#9
Andrew Smith, Wendy B Barr, Erin Bassett-Novoa, Nicholas LeFevre
Labor is defined as contractions with cervical change and active labor starts when the cervix is dilated 6 cm. Updated labor curves and definitions should be used to define labor dystocia. Oxytocin and amniotomy have important roles in the management of labor dystocia. Structured intermittent fetal monitoring should be considered for women with low-risk pregnancies but continuous electronic fetal monitoring still is used most commonly. Moderate fetal heart rate variability is the most reliable marker of fetal well-being...
April 2018: FP Essentials
https://www.readbyqxmd.com/read/29673659/effect-of-epidural-anesthesia-in-labor-pregnancy-with-cardiovascular-disease
#10
Hiroaki Tanaka, Chizuko Kamiya, Shinji Katsuragi, Kayo Tanaka, Jun Yoshimatsu, Tomoaki Ikeda
OBJECTIVE: We studied the effect and safety of epidural anesthesia during labor in pregnant women with cardiovascular disease. MATERIALS AND METHODS: In the pregnant women with cardiovascular disease, we compared maternal outcome and suppressive effect on blood pressure retrospectively between the epidural group (anesthetized epidurally during labor) and the no-epidural group (not anesthetized epidurally during labor). RESULTS: A total of 277 patients were included in the analyses...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29664554/extensive-postpartum-urinary-retention-successfully-treated-with-clean-intermittent-catheterization
#11
Paweł Milart, Ewa Beata Wozniakowska, Piotr Czuczwar, Wojciech Wrona, Tomasz Paszkowski
We present a case of extensive urine retention after vaginal delivery. Postpartum urinary retention occurs in 0.7 to 0.9% of vaginal deliveries. In the literature, mediolateral episiotomy, epidural analgesia, perineal lacerations, macrosomic birth and prolonged 2nd stage of labor are suggested as risk factors for postpartum urine retention.
2018: Ginekologia Polska
https://www.readbyqxmd.com/read/29664053/labor-onset-oxytocin-use-and-epidural-anesthesia-for-vaginal-birth-after-cesarean-section-and-associated-effects-on-maternal-and-neonatal-outcomes-in-a-tertiary-hospital-in-china-a-retrospective-study
#12
Shao-Wen Wu, He Dian, Wei-Yuan Zhang
Background: In the mainland of China, the trial of labor after cesarean section is still a relatively new technique. In this study, we aimed to investigate the effects of labor onset, oxytocin use, and epidural anesthesia on maternal and neonatal outcomes for vaginal birth after cesarean section (VBAC) in a tertiary hospital in China. Methods: This was a retrospective study carried out on 212 VBAC cases between January 2015 and June 2017 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29643617/comparison-of-ropivacaine-0-2-with-or-without-clonidine-1-%C3%AE-g-kg-for-epidural-labor-analgesia-a-randomized-controlled-study
#13
Indira Kumari, Kapil Sharma, Vikram Bedi, Madhan Mohan, Hemraj Tungaria, Manish Kumar Modi
Background and Aims: The aim is to determine the effect of addition of clonidine to ropivacaine for epidural labor analgesia with regard to onset of analgesia, duration of analgesia, neonatal outcome, and quality of analgesia. Material and Methods: A total of 60 term parturients of the American Society of Anesthesiologists Grade I and II with uncomplicated pregnancy, vertex presentation, posted for on-demand epidural labor analgesia after informed consent were divided in two groups...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643616/labor-analgesia-in-parturients-of-fetal-growth-restriction-having-raised-umbilical-doppler-vascular-indices
#14
Sukhen Samanta, Kajal Jain, Neerja Bhardwaj, Vanita Jain, Preet Mohinder Singh, Sujay Samanta, Veenu Singla, Rini Saha
Background and Aims: Fetuses with abnormal umbilical blood flow are at a higher risk of adverse perinatal outcome than those with normal flow. Epidural analgesia (EA) has shown to decrease villous vascular resistance in preeclamptic women during labor. The present study evaluates the effects of epidural ropivacaine and intramuscular (IM) tramadol on Doppler blood flow in parturients with fetal growth restriction and raised umbilical artery (UmA) blood flow. Material and Methods: In this prospective nonrandomized comparative study, 36 term parturients with sonographic evidence of UmA systolic-diastolic (S-D) ratio ≥3 were enrolled...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29642862/effectiveness-and-safety-of-moderate-intensity-aerobic-water-exercise-during-pregnancy-for-reducing-use-of-epidural-analgesia-during-labor-protocol-for-a-randomized-clinical-trial
#15
Araceli Navas, Catalina Artigues, Alfonso Leiva, Elena Portells, Aina Soler, Antonia Cladera, Silvia Ortas, Margarita Alomar, Marina Gual, Concepción Manzanares, Marina Brunet, Magdalena Julià, Lidia López, Lorena Granda, Miquel Bennasar-Veny, Mari Carmen Carrascosa
BACKGROUND: Epidural analgesia during labor can provide effective pain relief, but can also lead to adverse effects. The practice of moderate exercise during pregnancy is associated with an increased level of endorphins in the blood, and this could also provide pain relief during labor. Aerobic water exercises, rather than other forms of exercise, do not negatively impact articulations, reduce edema, blood pressure, and back pain, and increase diuresis. We propose a randomized controlled trial (RCT) to evaluate the effectiveness and safety of a moderate water exercise program during pregnancy on the need for epidural analgesia during labor...
April 11, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29628855/editorial-commentary-on-using-dexamethasone-as-an-adjuvant-to-levobupivacaine-in-epidural-anesthesia-to-change-the-pain-intensity-and-duration-in-painless-labor
#16
https://www.readbyqxmd.com/read/29628829/using-dexamethasone-as-an-adjuvant-to-levobupivacaine-in-epidural-anesthesia-to-change-the-pain-intensity-and-duration-in-painless-labor
#17
Hassan Mohamed Ali, Amr Wahdan
Background and Objective: This is a randomized controlled trial aiming at comparing the effectiveness of levobupivacaine alone versus a levobupivacaine with dexamethasone in the epidural injection for painless labor. Patients and Methods: This is a comparative randomized controlled double-blinded clinical trial with 49 patients were included in this study, all of them were primigravidas and were during vaginal delivery with a cervical dilatation ≥4 cm. Patients were included randomly in one of two groups either Group C (26 cases) with epidural levobupivacaine 0...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628556/comparison-of-three-different-concentrations-of-levobupivacaine-for-epidural-labor-analgesia-clinical-effect-and-pharmacokinetic-profile
#18
Ahmed Mostafa El-Shaarawy, Mohamed S Asfour, Doaa A Rashwan, Mahmoud M Amer, Shahira F El-Menshawe, Mohammed H Elkomy
Background: The aim is to compare the clinical effect of three different concentrations of levobupivacaine (0.25%, 0.125%, and 0.0625%) on the sensory and motor block characteristics and mode of delivery during epidural labor analgesia. We also studied the pharmacokinetic profile of the three concentrations during labor. Materials and Methods: Sixty pregnant females undergoing normal vaginal delivery under epidural analgesia were divided into three groups according to the concentration of levobupivacaine used...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29607491/increased-single-balloon-foley-catheter-volume-for-induction-of-labor-and-time-to-delivery-a-systematic-review-and-meta-analysis
#19
REVIEW
Corina N Schoen, Gabriele Saccone, Sami Backley, Evelien M Sandberg, Ning Gu, Shani Delaney, Vincenzo Berghella
INTRODUCTION: Induction of labor is a common intervention. The objective was to investigate whether larger Foley catheter volumes for labor induction decrease the total time from induction to delivery. MATERIAL AND METHODS: Randomized controlled trials comparing larger single-balloon volumes (60-80 mL) during Foley catheter cervical ripening with usual volume (30 mL) in women undergoing labor induction were identified by searching electronic databases (MEDLINE, Scopus, ClinicalTrials...
April 1, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29603114/maternal-quality-of-life-in-routine-labor-epidural-analgesia-versus-labor-analgesia-on-request-results-of-a-randomized-trial
#20
A A S van den Bosch, M Goossens, K Bonouvrié, B Winkens, J G Nijhuis, F J M E Roumen, M M L H Wassen
INTRODUCTION: The purpose of this study was to evaluate the changes in maternal quality of life (QOL) from pregnancy to 6 weeks after delivery between routine labor epidural analgesia (EA) and pain relief on maternal request only. METHODS: \Women delivering of a singleton in cephalic presentation beyond 36 + 0 weeks' gestation were randomly allocated to EA as a routine during labor (routine EA group), or to any kind of analgesia on request only (control group)...
March 30, 2018: Quality of Life Research
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