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Pain management in labor

Silvana Granado Nogueira da Gama, Elaine Fernandes Viellas, Jacqueline Alves Torres, Maria Helena Bastos, Odaléa Maria Brüggemann, Mariza Miranda Theme Filha, Arthur Orlando Correa Schilithz, Maria do Carmo Leal
BACKGROUND: The participation of nurses and midwives in vaginal birth care is limited in Brazil, and there are no national data regarding their involvement. The goal was to describe the participation of nurses and nurse-midwives in childbirth care in Brazil in the years 2011 and 2012, and to analyze the association between hospitals with nurses and nurse-midwives in labor and birth care and the use of good practices, and their influence in the reduction of unnecessary interventions, including cesarean sections...
October 17, 2016: Reproductive Health
Everett F Magann, Kinsey I Dinnel, Nader Z Rabie, Amanda L Shoemaker, Nirvana A Manning
BACKGROUND A spontaneous intra-amniotic hemorrhage is rarely encountered during pregnancy. The correct diagnosis and management are problematic because of the infrequency of this condition and the high likelihood of a misdiagnosis. CASE REPORT A primigravida with an uncomplicated pregnancy and a normal targeted ultrasound presented late in the second trimester of pregnancy with antepartum bleeding of unknown origin. A repeat ultrasound was suggestive of an abdominal wall defect (gastroschisis). The patient continued to have antepartum bleeding and developed uterine contractions and abdominal pain necessitating frequent visits to labor and delivery...
October 20, 2016: American Journal of Case Reports
Anna Livshits, Daniel S Seidman
This review summarizes the current use of non-steroidal anti-inflammatory drugs (NSAIDs) in obstetrics, gynecology and infertility. These medications are commonly used in different fields of reproductive medicine, for pain management after operative procedures and to relieve dysmenorrhea. In addition to their analgesic effect, NSAIDs are helpful in the management of menorrhagia by decreasing menstrual blood loss. NSAIDs alleviate pain associated with medical abortion, assist in undertaking natural cycle in-vitro fertilization by preventing follicular rupture and reducing premature ovulation, and serve as tocolytics in preterm labor...
July 5, 2010: Pharmaceuticals
A-C Pfeifer, B Ditzen, E Neubauer, M Schiltenwolf
BACKGROUND: Over the years the effect of the neuropeptide oxytocin and its possible utilization for pain management has been increasingly more investigated and discussed. Initial results emphasized the effects of oxytocin with respect to labor and breastfeeding. Diverse animals studies were also able to demonstrate the effectiveness of the peptide in attachment behavior and pain perception; however, it is still unclear how oxytocin affects pain perception in humans. The potential therapeutic effectiveness of oxytocin could be particularly important for primary and secondary treatment of pain patients because chronification of pain can occur more frequently in this area...
October 2016: Der Schmerz
Lily Lee, Jessica Dy, Hussam Azzam
OBJECTIVE: The purpose of this guideline is to provide guidance for the intrapartum management of spontaneous labour, whether normal or abnormal, in term, healthy women, and to provide guidance in the management of first and second stage dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Odaléa Maria Brüggemann, Erika Simas Ebsen, Romana Raquel Ebele, Bruna Daniela Batista
Qualitative research, with an exploratory and descriptive approach, was conducted between September 2011 and February 2012, aimed at revealing the possibility of inclusion of the partner in deliveries in institutions that currently restrict their presence. Twelve nurses responsible for obstetric centers and five technical directors of health institutions of Santa Catarina, who did not allow or infrequently allowed the presence of the partner during delivery, were interviewed. Data were analyzed using Bardin Content Analysis, with the support of ATLAS...
August 2016: Ciência & Saúde Coletiva
Justin J Ernat, Craig R Bottoni, Douglas J Rowles
Humeral avulsion of the glenohumeral ligament (HAGL) is a lesion that has been recognized as a cause of recurrent shoulder instability. To our knowledge there are no reports of successful return to full function in young, competitive athletes or return to manual labor following nonoperative management of a HAGL lesion. A 26-year-old Navy SEAL was diagnosed with a HAGL injury, and associated traction injury of the axillary nerve as well as a partial tear of the rotator cuff. Operative intervention was recommended; however, due to issues with training and with inability to properly rehab with the axillary nerve injury, surgical plans were delayed...
July 2016: American Journal of Orthopedics
Simin Taavoni, Fatemeh Sheikhan, Somayeh Abdolahian, Fatemeh Ghavi
OBJECTIVE: Labor pain and its management is a major concern for childbearing women, their families and health care providers. This study aimed to investigate the effects of two non-pharmacological methods such as birth ball and heat therapy on labor pain relief. MATERIAL & METHODS: This randomized control trial was undertaken on 90 primiparous women aged 18-35 years old who were randomly assigned to two intervention (birth ball and heat) and control groups. The pain score was recorded by using Visual Analogue Scale (VAS) before the intervention and every 30 min in three groups until cervical dilatation reached 8 cm...
August 2016: Complementary Therapies in Clinical Practice
Sami Roukoz, Linda Nabhane, Ali al-rida Aidibi, Amer Sebaaly
BACKGROUND: Muscle transfer has been reported as a good surgical option to reconstruct the deficient rotator cuff. The purpose of this study is to report the outcome of deltoid muscle flap transfer to restore shoulder function in patients with massive irreparable rotator cuff tear. MATERIAL AND METHODS: This is a retrospective descriptive case series. Included patients had a lesion of two or more tendons of the rotator cuff or lesion of one tendon of more than 5 cm in width and no lesion to the subscapularis...
January 2016: Le Journal Médical Libanais. the Lebanese Medical Journal
Jagannath Dattatreya Dixit, Shiraz Ahamed Sharief, Manish Kumar Goyal, Sameeha Khan, Lubna Kauser
Plexiform Angiomyxoid Myofibroblastic Tumor (PAMT) is a recently identified mesenchymal tumor of the stomach, which was first described in the year 2007 and was added in the 2010 WHO classification of tumors of the digestive system World J Gastroenterol 16(6): 2835-2840, 2010. It closely resembles with other gastric tumors but distinctly varies in clinical management as well as the histopathology. We had a 51 year, female patient, laborer by profession with low socio economic status, who had abdominal pain with vomiting since 6 months...
March 2016: Indian Journal of Surgical Oncology
Dinesh K Choudhry, B Randall Brenn, Karen Sacks, Kirk Reichard
BACKGROUND: Pain following Nuss procedure is severe and its management is challenging. Many different pain treatment modalities are currently being used, but none of them have been found to be ideal. AIM: In this retrospective review, we compare our current multimodal approach, which involves continuous ropivacaine infusion through chest wall catheters (CWC), intravenous patient-controlled analgesia (IV-PCA), and adjunctive medications (gabapentin and clonidine), with the technique that we used in the past, the thoracic epidural catheter (TEC)...
June 2016: Paediatric Anaesthesia
Shun Lu, Junwei Wu, Baisheng Fu, Jinlei Dong, Yongliang Yang, Maoyuan Xin, Guodong Wang, Tong-Chuan He, Dongsheng Zhou
While uncommon, post-traumatic pelvic malunions present reconstructive challenges and are associated with significant disability and financial burden. A transiliac osteotomy is a surgical technique useful to correct certain types of pelvic fracture malunions, and is only used when the correction of a limb-length discrepancy is the primary goal. This study aims to present our experience with this technique in the treatment of post-traumatic pelvic malunions. Eight patients who underwent transiliac osteotomies for post-traumatic pelvic malunions at our department from 2006 to 2011 were included in this study...
March 2016: Medicine (Baltimore)
Yutaka Yoneoka, Shoji Kaku, Shunichiro Tsuji, Hiroto Yamashita, Takashi Inoue, Fuminori Kimura, Takashi Murakami
BACKGROUND: Vesicoureteral reflux is thought to predispose to urinary tract infection and renal scarring, and ureteral reimplantation in childhood remains the gold standard for its treatment. It has been reported that the risk of postrenal failure during pregnancy is increased among women with Politano-Leadbetter ureteral reimplantation. In previous case reports on patients with progressive hydronephrosis and renal failure during pregnancy after ureteral reimplantation, percutaneous nephrostomy was always required, so there has been no information about the clinical management of such patients by ureteral stenting...
2016: BMC Pregnancy and Childbirth
Marschall B Berkes, Joshua S Dines, Jacqueline F Birnbaum, Lionel E Lazaro, Tristan C Lorich, Milton T M Little, Joseph T Nguyen, Dean G Lorich
BACKGROUND: Convention dictates that an axillary view be obtained when evaluating proximal humerus fractures (PHF). However, the axillary view is frequently omitted because of pain and technical considerations. Furthermore, its diagnostic utility is unclear in this setting. QUESTIONS/PURPOSES: The purpose of this study was to (1) determine the rate of obtaining an adequate axillary X-ray and complete shoulder series at a level I trauma center, (2) understand the cost of ordering and attempting an axillary radiograph, and (3) determine if axillary radiographs influence the management of PHF...
October 2015: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Aleena Banerji, Marc Riedl
Hereditary angioedema (HAE) is a rare disorder resulting from decreased functional levels of C1-inhibitor (C1-INH), which manifests as periodic episodes of localized edema which can be extremely painful, debilitating and even fatal if the swelling affects the larynx. HAE can complicate many aspects of obstetric/gynecologic care, and an awareness of the disease is critical for clinicians involved in the care of women because of potential HAE-related complications pertaining to pregnancy, labor and delivery, and other women's health issues...
June 2016: Women's Health
Denise Moreau, Viola Polomeno, Catherine De Pierrepont, Jocelyne Tourigny, Marie-Christine Ranger
In the last few years, there has been an important decrease in parents' interest and participation in prenatal classes in Canada and elsewhere in the world. Partial results were obtained on parenting couples' participation in and satisfaction with prenatal classes, from a larger study involving 103 francophone couples living in Ottawa, using'a mixed methods descriptive and longitudinal research design. This article aims to present the reasons why parents do not participate in prenatal classes and their suggestions to improve them...
December 2015: Recherche en Soins Infirmiers
Gayle McLelland, Lisa McKenna, Amee Morgans, Karen Smith
OBJECTIVE: To report on clinical and socio-demographic factors of a one-year caseload of women attended by a statewide ambulance service in Australia, who presented during pregnancy, prior to the commencement of labor. METHODS: Retrospective clinical data collected via in-field electronic patient care record (VACIS®) by paramedics during clinical management was provided by Ambulance Victoria. Cases were electronically extracted from the Ambulance Victoria Clinical Data Warehouse via comprehensive filtering followed by case review...
July 2016: Prehospital Emergency Care
Sudipta Sen, Sailesh Arulkumar, Elyse M Cornett, Julie A Gayle, Ronda R Flower, Charles J Fox, Alan D Kaye
Perioperative management of patients receiving opioid addiction therapy presents a unique challenge for the anesthesiologist. The goal of pain management in this patient population is to effectively manage postoperative pain, to improve patient satisfaction and outcomes, and to reduce the cost of health care. Multimodal analgesics, including nonsteroid anti-inflammatory drugs, intravenous acetaminophen, gabapentanoid agents, and low-dose ketamine infusions, have been used to improve postoperative pain and to reduce postoperative opioid use...
March 2016: Current Pain and Headache Reports
Veerandra Koyyalamudi, Gurleen Sidhu, Elyse M Cornett, Viet Nguyen, Carmen Labrie-Brown, Charles J Fox, Alan D Kaye
Presently, the gold standard for pain control in laboring patients is neuraxial blockade, which includes a spinal, epidural, or a combined spinal-epidural technique. In conjunction with neuraxial blockade or by itself, some of the other agents employed related to labor pain include opioids, non-opioids, nitrous oxide, patient-controlled analgesia (PCA), and distraction therapy. Alternative treatments include acupuncture, hypnotism, yoga, exercise during pregnancy, hydrotherapy, transcutaneous electronic nerve stimulation, massage, and relaxation techniques...
February 2016: Current Pain and Headache Reports
M Rezk, E S El-Shamy, A Massod, R Dawood, R Habeeb
OBJECTIVES: This trial aimed to ascertain the relative efficacy, adverse effects, and acceptability of fentanyl versus pethidine for pain relief during labour. MATERIALS AND METHODS: Parturients (n=80) in the active phase who requested analgesia were randomly assigned to receive either intravenous fentanyl (n=40) or intramuscular pethidine (n=40). Pain scores hourly, maternal and fetal adverse effects, neonatal outcome, and maternal acceptability were assessed. RESULTS: Pain scores decreased in both groups, the decrease varying from mild to moderate, average pain scores remaining above 3...
2015: Clinical and Experimental Obstetrics & Gynecology
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