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Pain management in labor

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https://www.readbyqxmd.com/read/28448331/a-nurse-directed-model-for-nitrous-oxide-use-during-labor
#1
Toni Pinyan, Kelly Curlee, Mellanie Keever, Kathleen M Baldwin
BACKGROUND: Nitrous oxide has a long history of use and has been well documented in the literature as a safe, effective, and inexpensive option for pain management in labor in other countries, but it is underused in the United States. LOCAL PROBLEM: Pain relief options for laboring women in rural community hospitals with a small perinatal service are limited due to lack of availability of in-house anesthesia coverage. METHOD: This quality improvement project involved development and implementation of a nurse-driven, self-administered, demand-flow nitrous oxide program as an option for pain relief for laboring women in a rural community hospital...
May 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28382061/effect-of-breathing-technique-of-blowing-on-the-extent-of-damage-to-the-perineum-at-the-moment-of-delivery-a-randomized-clinical-trial
#2
Zohre Ahmadi, Shahnaz Torkzahrani, Firouze Roosta, Nezhat Shakeri, Zohre Mhmoodi
INTRODUCTION: One of the important tasks in managing labor is the protection of perineum. An important variable affecting this outcome is maternal pushing during the second stage of labor. This study was done to investigate the effect of breathing technique on perineal damage extention in laboring Iranian women. MATERIALS AND METHODS: This randomized clinical trial was performed on 166 nulliparous pregnant women who had reached full-term pregnancy, had low risk pregnancy, and were candidates for vaginal delivery in two following groups: using breathing techniques (case group) and valsalva maneuver (control group)...
January 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28376565/implementation-of-a-hydrotherapy-protocol-to-improve-postpartum-pain-management
#3
Meghann Batten, Eleanor Stevenson, Deb Zimmermann, Christine Isaacs
INTRODUCTION: A growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth. PROCESS: The postpartum hydrotherapy protocol was initiated in a certified nurse-midwife (CNM) practice in an urban academic medical center...
March 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28371224/use-of-an-early-labor-lounge-to-promote-admission-in-active-labor
#4
Julie A Paul, Susan M Yount, Rachel Blankstein Breman, Melissa LeClair, Diane M Keiran, Nannette Landry, Kimberly Dever
Professional maternity care organizations within the United States are aligned in the goal to prevent the first cesarean birth in nulliparous women with a term, singleton, vertex fetus. Currently, one in 3 women are at risk for having a cesarean birth. The most common reason for cesarean in the United States is labor dystocia. The evidence supports delaying admission to the birthing unit until active labor is established, thereby minimizing the inadvertent diagnosis of labor dystocia. Providers are familiar with the rationale supporting delayed admission to the birthing unit until active labor is established; however, there is very little evidence on how to effectively promote this delay...
March 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28333819/practice-bulletin-no-177-obstetric-analgesia-and-anesthesia
#5
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333811/practice-bulletin-no-177-summary-obstetric-analgesia-and-anesthesia
#6
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28298774/a-survey-on-awareness-about-the-role-of-anesthesia-and-anesthesiologists-among-the-patients-undergoing-surgeries-in-a-tertiary-care-teaching-women-and-children-hospital
#7
Vinay Marulasiddappa, H N Nethra
BACKGROUND: Although anesthesiology has grown tremendously and although anesthesiologists play a crucial role in the perioperative management of patients and also outside operating theater (OT) such as critical care, pain clinic, and labor analgesia, they do not get due recognition. We conducted a study to assess the awareness about the role of anesthesia and anesthesiologists among patients scheduled to undergo surgery in a Government Tertiary Care Teaching Women and Children Hospital...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28284462/an-observational-study-of-agreement-between-percentage-pain-reduction-calculated-from-visual-analog-or-numerical-rating-scales-versus-that-reported-by-parturients-during-labor-epidural-analgesia
#8
E Pratici, S Nebout, N Merbai, J Filippova, D Hajage, H Keita
BACKGROUND: This study aimed to determine the level of agreement between calculated percentage pain reduction, derived from visual analog or numerical rating scales, and patient-reported percentage pain reduction in patients having labor epidural analgesia. METHODS: In a prospective observational study, parturients were asked to rate their pain intensity on a visual analog scale and numerical rating scale, before and 30min after initiation of epidural analgesia...
February 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28283828/risk-factors-and-peripartum-outcomes-of-failed-epidural-a-prospective-cohort-study
#9
Carmen Bucstain, Gali Garmi, Noah Zafran, Sivan Zuarez-Easton, Julia Carmeli, Raed Salim
PURPOSE: Awareness to rate, risk factors, and the associated peripartum outcomes of failed epidural analgesia (FEA) may improve expectations and labor management. We aimed to identify risk factors for FEA and to examine peripartum outcomes associated with failure. METHODS: A prospective cohort study conducted between March 2015 and August 2015, at a single university medical center. Laboring women at ≥34 weeks, receiving epidural analgesia, were eligible. Pain was evaluated using a 0-10 cm visual analogue scale (VAS)...
March 10, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28282777/comparing-the-effect-of-e-learning-and-educational-booklet-on-the-childbirth-self-efficacy-a-randomized-controlled-clinical-trial
#10
Parastoo Abbasi, Sakineh Mohammad-Alizadeh Charandabi, Mojgan Mirghafourvand
PURPOSE: This study aimed to compare the effect of e-learning and educational booklet on the childbirth self-efficacy (CBSE). METHODS: This randomized controlled clinical trial was conducted on 153 pregnant women referred to health centers in the city of Miandoab, Iran in 2015-2016. Participants were assigned into two intervention groups (e-learning and educational booklet) and the control group. A single face-to-face session was held for intervention groups about the management of labor pain in 30-34 weeks of pregnancy and the booklet and software were provided...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28217686/pregnancy-related-osteoporosis-and-spinal-fractures
#11
Ka Yeong Yun, Si Eun Han, Seung Chul Kim, Jong Kil Joo, Kyu Sup Lee
Pregnancy-related osteoporosis is a very rare condition characterized by the occurrence of fracture during pregnancy or the puerperium. Despite its relative rarity, it can be a dangerous condition that causes severe back pain, height loss and disability. Normal physiologic changes during pregnancy, genetic or racial difference, obstetrical history and obstetrical disease, such as preterm labor or pregnancy-induced hypertension, are presumed risk factors of pregnancy-related osteooporosis. However, exact etiology and pathogenesis are uncertain...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28217071/difficulty-in-the-removal-of-epidural-catheter-for-labor-analgesia
#12
Mohamed S Hajnour, Rashid Saeed Khokhar, Abdul Aziz Ahmed Ejaz, Tariq Al Zahrani, Naveed Uddin Kanchi
For labor pain management epidural analgesia is a popular and an effective method. Difficult removal of epidural catheters occasionally occurs, and several maneuvers have been recommended. The purpose of this article is to raise awareness of the problem of retained epidural catheter fragments and identify the potential impact of complications.
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28210635/combined-spinal-epidural-for-vaginal-delivery-in-a-parturient-with-takayasu-s-arteritis
#13
Sean Patrick Clifford, Paul Brian Mick, Brian Matthew Derhake
Takayasu's arteritis is a rare, progressive panendarteritis involving all layers of the arterial wall. This disease includes variable involvement of the aorta and its major branches. The most common complication with this condition is severe, uncontrolled hypertension, often leading to end organ dysfunction. We describe the management of a 27-year-old woman diagnosed with Takayasu's arteritis that presented in labor with intense pain and underwent a combined spinal-epidural for anesthetic management. Per literature review, a combined spinal-epidural technique for planned vaginal delivery has not been described for a laboring Takayasu patient...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28208053/retrospective-cohort-study-of-hydrotherapy-in-labor
#14
Jennifer Vanderlaan
OBJECTIVE: To describe the use of hydrotherapy for pain management in labor. DESIGN: This was a retrospective cohort study. SETTING: Hospital labor and delivery unit in the Northwestern United States, 2006 through 2013. PARTICIPANTS: Women in a nurse-midwifery-managed practice who were eligible to use hydrotherapy during labor. METHODS: Descriptive statistics were used to report the proportion of participants who initiated and discontinued hydrotherapy and duration of hydrotherapy use...
February 13, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28165843/birth-place-preferences-and-women-s-expectations-and-experiences-regarding-duration-and-pain-of-labor
#15
Tamar M van Haaren-Ten Haken, Marijke J Hendrix, Marianne J Nieuwenhuijze, Raymond G de Vries, Jan G Nijhuis
INTRODUCTION: We know a great deal about how childbirth is affected by setting; we know less about how the experience of birth is shaped by the attitudes women bring with them to the birthing room. In order to better understand how women frame childbirth, we examined the relationship between birth place preference and expectations and experiences regarding duration of labor and labor pain in healthy nulliparous women. METHODS: A prospective cohort study (2007-2011) of 454 women who preferred a home birth (n = 179), a midwife-led hospital birth (n = 133) or an obstetrician-led hospital birth (n = 142) in the Netherlands...
February 6, 2017: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28121831/committee-opinion-no-687-approaches-to-limit-intervention-during-labor-and-birth
#16
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28121830/committee-opinion-no-687-summary-approaches-to-limit-intervention-during-labor-and-birth
#17
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28121757/the-perinatal-birth-environment-communication-strategies-and-processes-for-adherence-to-a-standardized-guideline-in-women-undergoing-second-stage-labor-with-epidural-anesthesia
#18
Samantha A Sommerness, Rebecca Gams, Phillip N Rauk, Ananta Bangdiwala, Daniel V Landers, Melissa D Avery, Charles Hirt, Kristi Miller, Amy Millar, Suzin Cho, Andrea Shields
Key to any perinatal safety initiative is buy-in and strong leadership from obstetric and pediatric providers, advanced practice nurses, and labor and delivery nurses in collaboration with ancillary staff. In the fall of 2007, executives of a large Midwestern hospital system created the Zero Birth Injury Initiative. This multidisciplinary group sought to eliminate birth injury using the Institute of Healthcare Improvement Perinatal Bundles. Concurrently, the team implemented a standardized second-stage labor guideline for women who choose epidural analgesia for pain management to continue the work of eliminating birth injuries in second-stage labor...
January 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28072678/pain-anxiety-and-fatigue-during-labor-a-prospective-repeated-measures-study
#19
Ya-Ling Tzeng, Ya-Ling Yang, Pi-Chao Kuo, Ya-Chuan Lin, Shu-Ling Chen
BACKGROUND: Pain, anxiety, and fatigue are known to significantly influence labor; however, the interacting relationships among the three symptoms have not been empirically shown. PURPOSE: The aim of this study was to investigate the interrelationships among intrapartum pain, anxiety, and fatigue relative to the mode of delivery, with or without epidural analgesia (EDA). METHODS: A prospective, repeated measures design was adopted, and women with uncomplicated pregnancies at term (N = 186) were enrolled...
February 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/27917213/efficacy-of-early-skin-to-skin-contact-on-the-rate-of-exclusive-breastfeeding-in-term-neonates-a-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Amit Sharma
BACKGROUND: Despite multiple benefits of breast milk, the rates of exclusive breastfeeding in developing countries are low. OBJECTIVE: To evaluate the efficacy of early skin -to -skin contact (SSC) on the rate of exclusive breastfeeding (EBF) at 6 weeks of age among term neonates born by vaginal delivery. METHODS: Term neonates born by vaginal delivery and did not require any resuscitation were randomized at birth to SSC (n=100) and control (n=100) group...
September 2016: African Health Sciences
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