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Analgesia, labour

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https://www.readbyqxmd.com/read/29047128/onset-of-labour-epidural-analgesia-with-low-dose-bupivacaine-and-different-doses-of-fentanyl
#1
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
#2
(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
#3
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
#4
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
#5
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 9, 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
#6
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...
September 11, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
August 2, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28750275/special-attention-to-women-experiencing-high-risk-pregnancy-delivery-care-assistance-and-neonatal-outcomes-in-two-brazilian-maternity-wards
#16
Juliana Vieira Nazareth, Kleyde Ventura de Souza, Mark Anthony Beinner, Juliana Silva Barra, Odaléa Maria Brüggemann, Adriano Marçal Pimenta
BACKGROUND: To compare two care models of high-risk pregnant women--a House for Pregnant Women, staffed by nurse-midwives, versus a traditional care model in a hospital maternity ward. DESIGN: This was across-sectional study conducted in two reference maternity hospitals for high-risk pregnancies, in Belo Horizonte, Minas Gerais, Brazil. The sample consisted of 312 high-risk pregnant women consecutively admitted from January 1st to December 31(st), 2010, either to the House for Pregnant Women (n=247), or the hospital maternity ward (n=65)...
October 2017: Midwifery
https://www.readbyqxmd.com/read/28735031/taking-the-alternative-route-women-s-experience-of-intranasal-fentanyl-subcutaneous-fentanyl-or-intramuscular-pethidine-for-labour-analgesia
#17
Julie-Anne Fleet, Meril Jones, Ingrid Belan
OBJECTIVE: To compare women's experience of receiving either intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia. DESIGN: A content analysis was undertaken as part of the third phase of a larger randomised controlled trial, using the per-protocol dataset to examine women's experiences of treatment received. Healthy women birthing at term, who received intranasal fentanyl (n=41), subcutaneous fentanyl (n=37) and/or intramuscular pethidine (n=38) for labour analgesia, were contacted at 6 weeks postpartum to complete a phone questionnaire...
October 2017: Midwifery
https://www.readbyqxmd.com/read/28706102/a-method-to-assess-obstetric-outcomes-using-the-10-group-classification-system-a-quantitative-descriptive-study
#18
Janne Rossen, Miha Lucovnik, Torbjørn Moe Eggebø, Natasa Tul, Martina Murphy, Ingvild Vistad, Michael Robson
OBJECTIVES: Internationally, the 10-Group Classification System (TGCS) has been used to report caesarean section rates, but analysis of other outcomes is also recommended. We now aim to present the TGCS as a method to assess outcomes of labour and delivery using routine collection of perinatal information. DESIGN: This research is a methodological study to describe the use of the TGCS. SETTING: Stavanger University Hospital (SUH), Norway, National Maternity Hospital Dublin, Ireland and Slovenian National Perinatal Database (SLO), Slovenia...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28698953/what-can-we-do-to-reduce-the-associated-costs-in-induction-of-labour-of-intrauterine-growth-restriction-foetuses-at-term-a-cost-analysis-study
#19
Jorge Duro-Gómez, María Fernanda Garrido-Oyarzún, Ana Belén Rodríguez-Marín, Antonio Jesús de la Torre González, José Eduardo Arjona-Berral, Camil Castelo-Branco
OBJECTIVE: To evaluate the costs associated with induction of labour in intrauterine growth restriction fetuses comparing different procedures. STUDY DESIGN: 150 pregnancies at term diagnosed with intrauterine growth restriction and indication for induction of labour were included. 24 were ripened with misoprostol 25 μg tablets, 24 with dinoprostone 10 mg vaginal insert, and 77 with Cook(®) cervical ripening balloon. To determine the costs of induction of labour, method of induction, intrapartum medication, epidural analgesia, type of delivery, and maternal and neonatal admissions were considered...
July 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28695584/patient-controlled-analgesia-with-remifentanil-vs-alternative-parenteral-methods-for-pain-management-in-labour-a-cochrane-systematic-review
#20
REVIEW
Y Jelting, S Weibel, A Afshari, N L Pace, J Jokinen, T Artmann, L H J Eberhart, P Kranke
We aimed to assess the effectiveness of remifentanil used as intravenous patient-controlled analgesia for the pain of labour. We performed a systematic literature search in December 2015 (updated in December 2016). We included randomised, controlled and cluster-randomised trials of women in labour with planned vaginal delivery receiving patient-controlled remifentanil compared principally with other parenteral and patient-controlled opioids, epidural analgesia and continuous remifentanil infusion or placebo...
August 2017: Anaesthesia
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