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Analgesia, labour

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https://www.readbyqxmd.com/read/29197080/determination-of-the-optimal-programmed-intermittent-epidural-bolus-volume-of-bupivacaine-0-0625-with-fentanyl-2-%C3%AE-g-ml-1-at-a-fixed-interval-of-forty-minutes-a-biased-coin-up-and-down-sequential-allocation-trial
#1
P Zakus, C Arzola, R Bittencourt, K Downey, X Y Ye, J C Carvalho
The optimum time interval for 10 ml boluses of bupivacaine 0.0625% + fentanyl 2 μg.ml-1 as part of a programmed intermittent epidural bolus regimen has been found to be 40 min. This regimen was shown to be effective without the use of supplementary patient-controlled epidural analgesia boluses in 90% of women during the first stage of labour, although with a rate of sensory block to ice above T6 in 34% of women. We aimed to determine the optimum programmed intermittent epidural bolus volume at a 40 min interval to provide effective analgesia in 90% of women (EV90 ) during the first stage of labour, without the use of patient-controlled epidural analgesia...
December 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29137057/readability-of-internet-sourced-patient-education-material-related-to-labour-analgesia
#2
Nilay Boztas, Dilek Omur, Sule Ozbılgın, Gözde Altuntas, Ersan Piskin, Sevda Ozkardesler, Volkan Hanci
We evaluated the readability of Internet-sourced patient education materials (PEMs) related to "labour analgesia." In addition to assessing the readability of websites, we aimed to compare commercial, personal, and academic websites.We used the most popular search engine (http://www.google.com) in our study. The first 100 websites in English that resulted from a search for the key words "labour analgesia" were scanned. Websites that were not in English, graphs, pictures, videos, tables, figures and list formats in the text, all punctuation, the number of words in the text is less than 100 words, feedback forms not related to education, (Uniform Resource Locator) URL websites, author information, references, legal disclaimers, and addresses and telephone numbers were excluded...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29110753/a-multicentre-randomised-controlled-trial-of-position-during-the-late-stages-of-labour-in-nulliparous-women-with-an-epidural-clinical-effectiveness-and-an-economic-evaluation-bumpes
#3
Debra Bick, Annette Briley, Peter Brocklehurst, Pollyanna Hardy, Edmund Juszczak, Lynn Lynch, Christine MacArthur, Phillip Moore, Mary Nolan, Oliver Rivero-Arias, Julia Sanders, Andrew Shennan, Matt Wilson
BACKGROUND: Epidural analgesia leads to increased risk of instrumental vaginal delivery (IVD). There is debate about whether or not posture in second-stage labour influences the incidence of spontaneous vaginal birth (SVB). OBJECTIVES: In nulliparous women with epidural analgesia, does a policy of adopting an 'upright position' throughout second-stage labour increase the incidence of SVB compared with a policy of adopting a 'lying-down' position? DESIGN: Two-arm randomised controlled trial...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29095502/obstetric-outcomes-after-conservative-treatment-for-cervical-intraepithelial-lesions-and-early-invasive-disease
#4
REVIEW
Maria Kyrgiou, Antonios Athanasiou, Ilkka E J Kalliala, Maria Paraskevaidi, Anita Mitra, Pierre Pl Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
BACKGROUND: The mean age of women undergoing local treatment for pre-invasive cervical disease (cervical intra-epithelial neoplasia; CIN) or early cervical cancer (stage IA1) is around their 30s and similar to the age of women having their first child. Local cervical treatment has been correlated to adverse reproductive morbidity in a subsequent pregnancy, however, published studies and meta-analyses have reached contradictory conclusions. OBJECTIVES: To assess the effect of local cervical treatment for CIN and early cervical cancer on obstetric outcomes (after 24 weeks of gestation) and to correlate these to the cone depth and comparison group used...
November 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29054342/timing-of-hospital-admission-in-labour-latent-versus-active-phase-mode-of-birth-and-intrapartum-interventions-a-correlational-study
#5
A Rota, L Antolini, E Colciago, A Nespoli, S E Borrelli, S Fumagalli
BACKGROUND: Hospitalization of women in latent labour often leads to a cascade of unnecessary intrapartum interventions, to avoid potential disadvantages the recommendation should be to stay at home to improve women's experience and perinatal outcomes. AIM: The primary aim of this study was to investigate the association between hospital admission diagnosis (latent vs active phase) and mode of birth. The secondary aim was to explore the relationship between hospital admission diagnosis, intrapartum intervention rates and maternal/neonatal outcomes...
October 17, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29047128/onset-of-labour-epidural-analgesia-with-low-dose-bupivacaine-and-different-doses-of-fentanyl
#6
R Vedagiri Sai, S I Singh, F Qasem, D Nguyen, S Dhir, K Marmai, R Adam, P M Jones
This study investigated the effects of different doses of epidural fentanyl on the time to onset of epidural analgesia in women in early labour. We hypothesised that onset of epidural labour analgesia (the primary outcome defined as time in minutes from completion of epidural bolus to the first uterine contraction with a numeric pain rating scale [NPRS] score ≤ 3) would be faster with 100 μg of fentanyl epidural bolus compared with 20 μg or 50 μg. Epidural labour analgesia was initiated with 20 μg of fentanyl (F20 group), 50 μg (F50 group) or 100 μg (F100 group) along with 10 ml bupivacaine 0...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/29046273/upright-versus-lying-down-position-in-second-stage-of-labour-in-nulliparous-women-with-low-dose-epidural-bumpes-randomised-controlled-trial
#7
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Objective To determine whether being upright in the second stage of labour in nulliparous women with a low dose epidural increases the chance of spontaneous vaginal birth compared with lying down.Design Multicentre pragmatic individually randomised controlled trial.Setting 41 UK hospital labour wards.Participants 3093 nulliparous women aged 16 or older, at term with a singleton cephalic presentation and in the second stage of labour with epidural analgesia.Interventions Women were allocated to an upright or lying down position, using a secure web based randomisation service, stratified by centre, with no masking of participants or clinicians to the trial interventions...
October 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29045499/obstetric-and-psychological-characteristics-of-women-choosing-epidural-analgesia-during-labour-a-cohort-study
#8
Vasilis Sitras, Jūratė Šaltytė Benth, Malin Eberhard-Gran
OBJECTIVES: To investigate the obstetric and psychological characteristics of women who opt to use epidural analgesia (EDA) during labour and the impact of participating in labour preparation courses on women's decisions to use EDA. DESIGN: Longitudinal cohort study. SETTING: Akershus University Hospital, Norway. POPULATION: 2596 women with singleton pregnancies and intended vaginal delivery. METHODS: Data were collected using two self-completed questionnaires at pregnancy weeks 17 and 32...
2017: PloS One
https://www.readbyqxmd.com/read/29036756/acupuncture-or-acupressure-for-induction-of-labour
#9
REVIEW
Caroline A Smith, Mike Armour, Hannah G Dahlen
BACKGROUND: This is one of a series of reviews of methods of cervical ripening and labour induction. The use of complementary therapies is increasing. Women may look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice. Acupuncture involves the insertion of very fine needles into specific points of the body. Acupressure is using the thumbs or fingers to apply pressure to specific points. The limited observational studies to date suggest acupuncture for induction of labour has no known adverse effects to the fetus, and may be effective...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29031048/trends-in-perinatal-health-in-metropolitan-france-from-1995-to-2016-results-from-the-french-national-perinatal-surveys
#10
B Blondel, B Coulm, C Bonnet, F Goffinet, C Le Ray
OBJECTIVE: To study trends in the main indicators of perinatal health, medical practices and risk factors in France since 1995. POPULATION AND METHOD: All live births during one week in 1995 (n=13,318), 2003 (n=14,737), 2010 (n=14,903) and 2016 (n=13,384). Data were from interviews of women in postpartum wards and from medical records and were compared between years. RESULTS: Between 1995 and 2016, maternal age and body mass index increased steadily...
October 11, 2017: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/28942214/-it-s-your-body-but%C3%A2-mixed-messages-in-childbirth-education-findings-from-a-hospital-ethnography
#11
Elizabeth Newnham, Lois McKellar, Jan Pincombe
OBJECTIVE: to investigate the personal, social, cultural and institutional influences on women making decisions about using epidural analgesia in labour. In this article we discuss the findings that describe practices around the gaining of consent for an epidural in labour, which we juxtapose with similar processes relating to use of water for labour and/or birth. DESIGN: ethnography. SETTING: tertiary hospital in Australian city. PARTICIPANTS: sequential interviews were conducted with 16 women; hospital staff (primarily midwives and doctors) participated during six months of participatory observation fieldwork...
December 2017: Midwifery
https://www.readbyqxmd.com/read/28936608/the-effect-of-an-increased-pulse-width-on-the-pattern-of-motor-response-unilateral-versus-bilateral-during-the-tsui-test-in-labouring-parturients-a-randomized-crossover-trial
#12
Paul Zakus, Ricardo Bittencourt, Kristi Downey, Ban C H Tsui, Jose C A Carvalho
BACKGROUND AND OBJECTIVES: The typical response to the Tsui test performed via an epidural catheter placed in the lumbar area is the unilateral motor response of the lower limbs. Studies show that longer pulse widths can stimulate peripheral nerves at a lower threshold current from a farther distance. Therefore, we designed a study to test the hypothesis that epidural catheter stimulation with a 1.0-msec pulse width would increase the incidence of bilateral motor response in parturients when compared with stimulation with a 0...
September 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28898687/outcomes-of-mifepristone-usage-for-cervical-ripening-and-induction-of-labour-in-full-term-pregnancy-randomized-controlled-trial
#13
Oleg R Baev, Valentina P Rumyantseva, Oleg V Tysyachnyu, Olga A Kozlova, Gennady T Sukhikh
OBJECTIVE: The most commonly used approved indications for mifepristone in obstetrics include: termination of early pregnancy, cervical dilatation prior to abortion, labour induction in case of fetal death in utero. Fewer studies have been conducted on the effect of mifepristone on cervical ripening and induction of labour in term pregnancy with a live fetus. The aim of our study was to evaluate efficacy and safety of mifepristone use for cervical ripening and induction of labour versus expectant management in full-term pregnancy...
October 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28892762/risk-factors-and-symptoms-associated-with-maternal-and-neonatal-complications-in-women-with-uterine-rupture-a-16-years-multicentric-experience
#14
G A Markou, J-M Muray, C Poncelet
OBJECTIVE: high maternal and fetal morbidity and mortality levels have been associated with uterine ruptures. The aims of our study were to determine risk factors and signs for maternal and fetal complications in patients with uterine rupture. STUDY DESIGN: retrospective, population-based study, in all Val d'Oise public obstetrics departments, France, between 2000 and 2015. All patients with uterine rupture were analyzed using medical records. To identify risk factors and signs for maternal and fetal complications, patients were divided into two groups according to adverse maternal and fetal outcomes or not, and compared...
October 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28881046/a-meta-analysis-of-the-effect-on-maternal-health-of-upright-positions-during-the-second-stage-of-labour-without-routine-epidural-analgesia
#15
REVIEW
Ayse Deliktas, Kamile Kukulu
AIM: To detect the effect on maternal health of upright positions during the second stage of labour. BACKGROUND: Maternal position during labour has an important effect on maternal and foetal health. DESIGN: A meta-analysis was used based on the Cochrane Handbook. DATA SOURCES: Randomized/non-randomized clinical trials were searched with English and Turkish key words in databases (CINAHL, Medline, Science Direct, Springer Link, Ovid, Cochrane Central Register of Controlled Trials, Networked Digital Library of Theses & Dissertations, Proquest, ULAKBİM (Turkish Academic Network and Information Center) and YÖK (Turkish Council of Higher Education) (1970-December 2015)...
September 7, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28851782/evaluating-maternity-units-a-prospective-cohort-study-of-freestanding-midwife-led-primary-maternity-units-in-new-zealand-clinical-outcomes
#16
Celia P Grigg, Sally K Tracy, Mark Tracy, Rea Daellenbach, Mary Kensington, Amy Monk, Virginia Schmied
OBJECTIVE: To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand. DESIGN: Prospective cohort study. PARTICIPANTS: 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010-2011. All of the women planning a TMH birth were 'low risk', and 29 of the PMU cohort had identified risk factors...
August 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28838706/evaluation-of-an-information-pamphlet-for-women-considering-epidural-analgesia-in-labour
#17
Sarah B Munro, Amber Hui, Emily A Gemmell, Nahal Torabi, Angela S Johnston, Patricia A Janssen
OBJECTIVE: This study sought to assess change in knowledge and preference for epidural use associated with use of an information pamphlet and to explore women's decision-making and information needs regarding pain relief in labour. METHODS: Six focus groups with women who were pregnant or had given birth during the past 12 months were conducted in three northern communities in British Columbia. Following completion of a five-item knowledge pretest, women were randomly assigned to read either a short version or a detailed version of the pamphlet and then complete a post-test...
August 21, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28833337/maternal-body-mass-index-and-regional-anaesthesia-use-at-term-prevalence-and-complications
#18
Frances M Biel, Nicole E Marshall, Jonathan M Snowden
BACKGROUND: There is an evidence gap regarding the use of regional anaesthesia (epidural, spinal, or combined epidural/spinal anaesthesia) and associated complications by maternal body mass index (BMI). We examine associations between regional anaesthesia, mode of delivery, and regional anaesthesia complications by pre-pregnancy BMI categories among term deliveries. METHODS: Retrospective cohort study of births in California, 2007-2010, utilizing linked birth certificate data and patient discharge data...
August 22, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28794527/the-effect-of-addition-of-dexamethasone-to-levobupivacaine-in-parturients-receiving-combined-spinal-epidural-for-analgesia-for-vaginal-delivery
#19
Amr Samir Wahdan, Ahmed Ibrahim El-Sakka, Hassan Mostafa Ismail Gaafar
BACKGROUND AND AIMS: Regional analgesia is commonly used for the relief of labour pain, Prolongation of analgesia can be achieved by adjuvant medications. The aim of this randomised controlled trial was to evaluate the efficacy of intrathecal levobupivacaine with dexamethasone for labour analgesia. METHODS: A total of 80 females were included in this study, all were primigravidas undergoing vaginal delivery with cervical dilatation ≥4 cm and 50% or more effacement...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28766691/risk-factors-for-peripheral-nerve-injuries-following-neuraxial-labour-analgesia-a-nested-case-control-study
#20
G Haller, I Pichon, F-O Gay, G Savoldelli
BACKGROUND: Post-partum lower extremity motor and sensory dysfunctions occur in 0.1-9.2‰ of deliveries. While macrosomia, lithotomy position and forceps use are well-identified causes of peripheral nerve injuries, additional contributors such as patient condition and anaesthesia care may also have to be considered. METHODS: We performed a case-control study nested in a cohort of 19,840 patients having neuraxial anaesthesia for childbirth. Cases were all patients who developed motor or sensory dysfunction of lower extremities in the post-partum period...
October 2017: Acta Anaesthesiologica Scandinavica
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