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Analgesia, labour

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https://www.readbyqxmd.com/read/27918616/nitric-oxide-donors-for-cervical-ripening-and-induction-of-labour
#1
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
#2
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
#3
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
#4
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
#5
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...
September 22, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27799176/i-v-paracetamol-as-an-adjunct-to-patient-controlled-epidural-analgesia-with-levobupivacaine-and-fentanyl-in-labour-a-randomized-controlled-study
#6
K Gupta, S Mitra, S Kazal, R Saroa, V Ahuja, P Goel
BACKGROUND: Use of i.v. paracetamol for postoperative pain is well documented, but it is unclear if it can reduce the consumption of opioids during patient-controlled epidural analgesia (PCEA) in labouring parturients. METHODS: In this randomized, double-blind, placebo-controlled clinical trial conducted in a tertiary care hospital, (80)parturients were randomly assigned to two groups of 40 each, to receive either 1000 mg (100 ml) i.v. paracetamol or 100 ml normal saline as placebo, 30 min before the procedure...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27771320/-no-pain-no-gain-the-experience-of-women-using-sterile-water-injections
#7
Nigel Lee, Sue Kildea, Helen Stapleton
PROBLEM/BACKGROUND: Sterile water injections (SWI) are gaining popularity amongst women and midwives for the relief of back pain in labour. However the brief but intense pain associated with the injection has been cited as a deterrent to use and may negatively affect the birth experience. AIM: To explore women's experiences of using sterile water injections as analgesia for back pain in labour. DESIGN: A qualitative study, which generated data through individual semi-structured interviews with postnatal women...
October 19, 2016: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/27750477/patient-controlled-epidural-analgesia-for-labour-in-a-patient-after-ross-procedure-for-congenital-bicuspid-aortic-valve
#8
Satoshi Toyama, Yugo Tagaito, Megumi Shimoyama
No abstract text is available yet for this article.
October 18, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27726918/anaesthetic-management-of-parturients-with-univentricular-congenital-heart-disease-and-the-fontan-operation
#9
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27718435/suspected-total-spinal-in-patient-having-emergent-caesarean-section-a-case-report-and-literature-review
#10
H Virgin, E Oddby, J G Jakobsson
INTRODUCTION: Epidural analgesia is commonly used for management of pain during childbirth. Need for emergent Caesarean section e.g. because of signs of foetal distress or lack of progress is however not an uncommon event. In females having an established epidural; general anaesthesia, top-up of the epidural or putting a spinal are all possible options. Dosing of the spinal anaesthesia in females having epidural is a matter of discussion. PRESENTATION OF CASE: We describe a healthy 32 years, 0 para mother in gestation week 36 having labour epidural analgesia but due to foetal distress scheduled for an emergent Caesarean section category 2 that developed upper extremity weakness and respiratory depression after administration of standard dose high density bupivacaine/morphine/fentanyl intrathecal anaesthesia...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27701372/may-pre-procedure-neuroaxial-ultrasound-improve-the-identification-of-potential-epidural-space-when-compared-with-anatomical-landmarks-a-prospective-randomized-study
#11
Paolo Perna, Antonio Gioia, Riccardo Ragazzi, Carlo A Volta, Massimo Innamorato
BACKGROUND: Regional epidural analgesia is considered the gold standard for pain treatment in labour but the epidural catheter placement may be a difficult procedure because of the difficulty in anatomical landmarks palpation. These difficulties increase in pregnant women. Pre-procedure neuroaxial ultrasound may facilitate the procedure. METHODS: Prospectic randomized controlled study conducted in the Labour Ward. We randomized two groups of women undergoing epidural analgesia: Group A (28 patients), with loss of resistance technique and Group B (30 patients) with US assisted procedure...
October 4, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27668095/epidural-analgesia-with-ropivacaine-during-labour-in-a-patient-with-a-scn5a-gene-mutation
#12
A L M J van der Knijff-van Dortmont, M Dirckx, J J Duvekot, J W Roos-Hesselink, A Gonzalez Candel, C D van der Marel, G P Scoones, V F R Adriaens, I J J Dons-Sinke
SCN5A gene mutations can lead to ion channel defects which can cause cardiac conduction disturbances. In the presence of specific ECG characteristics, this mutation is called Brugada syndrome. Many drugs are associated with adverse events, making anesthesia in patients with SCN5A gene mutations or Brugada syndrome challenging. In this case report, we describe a pregnant patient with this mutation who received epidural analgesia using low dose ropivacaine and sufentanil during labour.
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/27608347/anaesthetists-experiences-with-the-early-labour-epidural-recommendation-for-obese-parturients-a-qualitative-study
#13
V A Eley, L K Callaway, A A J van Zundert, J Lipman, C Gallois
Caring for obese pregnant women presents challenges for all medical professionals. Despite a lack of supporting evidence, expert opinion and international guidelines suggest early labour epidural insertion for obese women. Anecdotally this is not supported by all anaesthetists. This qualitative study explored the experiences of anaesthetists regarding early epidural analgesia in obese parturients, to answer the research question: Are anaesthetists consistent in how they apply early epidural analgesia in obese parturients? Personal in-depth interviews with 42 specialist anaesthetists working in south-east Queensland, Australia, were completed between February and April, 2015...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27608337/anaesthetic-management-of-obese-parturients-what-is-the-evidence-supporting-practice-guidelines
#14
V A Eley, A A J van Zundert, J Lipman, L K Callaway
Increasing rates of obesity in western populations present management difficulties for clinicians caring for obese pregnant women. Various governing bodies have published clinical guidelines for the care of obese parturients. These guidelines refer to two components of anaesthetic care: anaesthetic consultation in the antenatal period for women with a body mass index (BMI) ≥ 40 kg/m(2) and the provision of early epidural analgesia in labour. These recommendations are based on the increased incidence of obstetric complications and the predicted risks and difficulties in providing anaesthetic care...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27604767/effect-of-epidural-analgesia-on-mode-of-delivery
#15
Ivka Djaković, Senka Sabolović Rudman, Vesna Košec
Continuous epidural analgesia is considered to be the gold standard of pain relief in labour. The objective of this study was to examine the connections between epidural analgesia and the frequency of instrument-assisted deliveries. We retrospectively analysed data encompassing epidural analgesia applications during 2012 and the connections with an increased frequency of instrumental deliveries. Out of 3157 births in 2012, epidural analgesia was used in 443 (14.03 %). Epidural analgesia significantly increased the number of instrumental deliveries with vacuum extraction (χ(2) = 35...
September 7, 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27601753/effective-management-of-post-labour-analgesia-post-dural-puncture-headache-with-mannitol
#16
Kalpana Rajendra Kulkarni, Rahul Rajarm Patil, Abhishek Ajay Wadhawan
No abstract text is available yet for this article.
August 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27524537/diclofenac-rectal-suppository-an-effective-modality-for-perineal-pain
#17
Shabnam Naz, Naila Yousuf Memon, Asma Sattar, Rafia Baloch
OBJECTIVE: To determine the frequency of perineal pain after childbirth after a single dose of diclofenac rectal suppository. METHODS: This cross-sectional study was conducted at Shaikh Zayed Women Hospital, Larkana, Pakistan, from April to September 2014, and comprised patients who were admitted to the labour room for normal vaginal delivery. A single dose of rectal diclofenac suppository of 100mg was given to the patients delivered vaginally or by second-stage emergency Caesarean section...
August 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27469988/adverse-obstetric-outcomes-after-local-treatment-for-cervical-preinvasive-and-early-invasive-disease-according-to-cone-depth-systematic-review-and-meta-analysis
#18
Maria Kyrgiou, Antonios Athanasiou, Maria Paraskevaidi, Anita Mitra, Ilkka Kalliala, Pierre Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
OBJECTIVE:  To assess the effect of treatment for cervical intraepithelial neoplasia (CIN) on obstetric outcomes and to correlate this with cone depth and comparison group used. DESIGN:  Systematic review and meta-analysis. DATA SOURCES:  CENTRAL, Medline, Embase from 1948 to April 2016 were searched for studies assessing obstetric outcomes in women with or without previous local cervical treatment. DATA EXTRACTION AND SYNTHESIS:  Independent reviewers extracted the data and performed quality assessment using the Newcastle-Ottawa criteria...
2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27459909/-assessment-of-maternal-satisfaction-with-epidural-analgesia-for-pain-control-during-labour
#19
V Marenco-Arellano, L Ferreira, E Ramalle-Gómara, A Crespo, A Rupérez, E Fraile
BACKGROUND: To determine the level of satisfaction and the sociodemographic characteristics of patients who receive epidural analgesia during labour. MATERIAL AND METHODS: A SERVQHOS questionnaire administered, with consecutive sampling, to 140 patients who had received an epidural anaesthetic for pain control during labour between January and June 2014, at the Hospital San Pedro. RESULTS: A total of 140 questionnaires were completed. The mean overall satisfaction (SERVQHOS scale) was 4...
July 23, 2016: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/27381020/local-birthing-services-for-rural-women-adaptation-of-a-rural-new-south-wales-maternity-service
#20
Michelle Durst, Margaret Rolfe, Jo Longman, Sarah Robin, Beverley Dhnaram, Kathryn Mullany, Ian Wright, Lesley Barclay
OBJECTIVE: To describe the outcomes of a public hospital maternity unit in rural New South Wales (NSW) following the adaptation of the service from an obstetrician and general practitioner-obstetrician (GPO)-led birthing service to a low-risk midwifery group practice (MGP) model of care with a planned caesarean section service (PCS). DESIGN: A retrospective descriptive study using quantitative methodology. SETTING: Maternity unit in a small public hospital in rural New South Wales, Australia...
July 6, 2016: Australian Journal of Rural Health
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