A retrospective case-controlled study of the association between request to discontinue second stage labor epidural analgesia and risk of instrumental vaginal delivery

2008 ◽  
Vol 17 (4) ◽  
pp. 304-308 ◽  
Author(s):  
P. Toledo ◽  
R.J. McCarthy ◽  
M.J. Ebarvia ◽  
C.A. Wong
Keyword(s):  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Controlled Study ◽  
Retrospective Case ◽  
Second Stage ◽  
Second Stage Labor ◽  
Labor Epidural

scholarly journals Reducing Length of Labor and Cesarean Surgery Rate Using a Peanut Ball for Women Laboring With an Epidural

2015 ◽  
Vol 24 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Christina Marie Tussey ◽  
Emily Botsios ◽  
Richard D. Gerkin ◽  
Lesly A. Kelly ◽  
Juana Gamez ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Lower Incidence ◽  
Nursing Intervention ◽  
Vaginal Birth ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Second Stage ◽  
Randomized Controlled ◽  
Second Stage Labor

ABSTRACTOne strategy for reducing the primary cesarean surgery rate and length of labor is using a peanut-shaped exercise ball for women laboring under epidural analgesia. A randomized, controlled study was conducted to determine whether use of a “peanut ball” decreased length of labor and increased the rate of vaginal birth. Women who used the peanut ball (n = 107) versus those who did not (n = 91) demonstrated shorter first stage labor by 29 min (p = .053) and second stage labor by 11 min (p < .001). The intervention was associated with a significantly lower incidence of cesarean surgery (OR = 0.41, p = .04). The peanut ball is potentially a successful nursing intervention to help progress labor and support vaginal birth for women laboring under epidural analgesia.

scholarly journals A randomized, double-blind, controlled study comparing Bupivacaine 0.125% and Ropivacaine 0.125%, both with Fentanyl 2 μg/ml, for labor epidural analgesia

2013 ◽  
Vol 27 (3) ◽  
pp. 147 ◽  
Author(s):  
Snigdha Paddalwar ◽  
Juhi Papalkar ◽  
Deepti Shrivastava ◽  
Aruna Chandak ◽  
Manda Nagrale
Keyword(s):  
Epidural Analgesia ◽  
Controlled Study ◽  
Double Blind ◽  
Labor Epidural

scholarly journals Labor epidural analgesia versus without labor epidural analgesia for multiparous women: a retrospective case control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuzhi Luo ◽  
Zhaowen Chen ◽  
Xujian Wang ◽  
Changyu Zhu ◽  
Shili Su
Keyword(s):  
Blood Loss ◽  
Epidural Analgesia ◽  
Group Analysis ◽  
Labor Pain ◽  
Retrospective Case ◽  
Cervical Dilation ◽  
Apgar Scores ◽  
Significant Difference ◽  
Multiparous Women ◽  
Labor Epidural

Abstract Background Labor epidural analgesia (LEA) effectively relieves the labor pain, but it is still not available consistently for multiparous women in many institutions because of their obviously shortened labor length. Methods A total of 811 multiprous women were retrospective enrolled and firstly divided into two groups: LEA group or non-LEA group. And then they were divided into seven subgroups and analyzed according to the use of LEA and cervical dilation. The primary outcomes (time intervals, blood loss and Apgar scores) and secondary outcomes (maternal demographic characteristics and birth weight) were collected by checking electronic medical records. Results The prevalence of using LEA in multiprous women was 54.5 %. Using LEA significantly lengthened the duration of labor stage by 56 min (P < 0.001), increased the blood loss (P < 0.001) and lowered Apgar scores (P = 0.001). In the comparison of sub-group analysis, using LEA can obviously prolong the duration of first-second stage in women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.014), while there was no significant difference with 4 cm or more cervical dilation (P = 0.69). Using LEA can significantly increased the blood loss when the initiation of LEA in the women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.035), meanwhile there were no significantly differences in the women with 4 cm or more cervical dilation (P = 0.524). Using LEA can significantly lower the Apgar scores when the initiation of LEA in the women with 2 cm cervical dilation (P = 0.001) and 4 cm or more cervical dilation (P = 0.025), while there were no significantly differences in the women with 3 cm cervical dilation (P = 0.839). Conclusions Labor epidural analgesia for the multiparous woman may alter progress of labor, increase postpartum blood loss and lower Apgar scores. Early or late initiation of LEA should be defined as with cervical dilatation of less or more than 3 cm and the different effect should be understand. Trial registration ChiCTR2100042746. Registered 27 January 2021-Prospectively registered, http://www.chictr.org.cn.

scholarly journals Comparison of the Effect of Epidural Bolus and Continuous Infusion of Lidocaine %1 on Pain, the Progress of Vaginal Delivery and Motor Function in Labor Epidural Analgesia

2021 ◽  
Author(s):  
Nahid Manouchehrian ◽  
Hossein Kimiaei Asadi ◽  
Soghra Rabiei ◽  
Abbas Moradi ◽  
Mansoure Nosrati
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Epidural Analgesia ◽  
Continuous Infusion ◽  
Pain Score ◽  
Vaginal Delivery ◽  
Motor Function ◽  
Continuous Group ◽  
P Value ◽  
Labor Epidural

Background: The pain of childbirth is the most severe pain that a woman experiences. This study aimed to compare the effect of epidural bolus and epidural continuous infusion of lidocaine %1 on pain and progress of vaginal delivery and motor function in labor epidural analgesia. Methods: This randomized clinical trial was conducted on 50 pregnant women aged between 18-45 years. They were randomly assigned into two groups of bolus injections of lidocaine1% and continuous infusion using an epidural approach. The evaluated variables included systolic and diastolic blood pressures, mean arterial pressure, pain score, heart rate, satisfaction rate, nausea, vomiting, itching, the progress of delivery, and the level of motor and sensory block. The collected data were analyzed in SPSS software (Version 21). P-value less than 0.05 was considered statistically significant. Results: Two groups were similar in age. There were no significant differences between two groups in terms of mean diastolic blood pressure, incidence of hypotension and C/S rate (P> 0.005). Mean arterial pressure, sedation score and neonatal Apgar scores in the first and fifth minutes in the continuous group were significantly lower than the bolus group. Pain score (VAS) in the bolus group) 2.55±1.04 (was significantly lower than infusion group (5.22±2.50). The length of the first and second stages of labor in the bolus group (42.28 and 34.12) was less than continuous infusion (47.04 and 47.00) (P< 0.005). Conclusion: In women undergoing epidural analgesia, epidural bolus injection of lidocaine 1% is associated with greater analgesia and satisfaction than continuous infusion.

scholarly journals Evaluation of pain relief and satisfaction in women using epidural analgesia in labour

2019 ◽  
Vol 8 (3) ◽  
pp. 1016
Author(s):  
Manisha C. Shembekar ◽  
Chaitanya A. Shembekar ◽  
Shantanu C. Shembekar ◽  
Jayshree J. Upadhye
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Normal Vaginal Delivery ◽  
Good Effect ◽  
Moderate Pain ◽  
Mild Pain ◽  
Section 8 ◽  
Second Stage ◽  
Vacuum Delivery

Background: Pain during childbirth is the most severe pain women may experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour.Methods: This retrospective study was carried out at Omega Hospital, Nagpur in 50 women in labour who demanded epidural analgesia for pain relief. It was carried out to determine extent of pain relief and overall satisfaction in women using epidural analgesia.Results: In present study, out of 50, 28 (56%) patients delivered by normal vaginal delivery, 14 (28%) patients delivered by cesarean section, 8 (16%) patients had vacuum delivery while in no patient forceps were applied. In first stage,36 (72%) patients had zero score (no pain), 13 (26%) patients had 1-3 score (mild pain) while 1 (2%) patient had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had very good effect in first stage in terms of pain scoring. In second stage, 13 (26%) patients had zero score (no pain), 31 (62%) had 1-3 score (mild pain) while 6 (12%) had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had good effect in second stage in terms of pain scoring. In terms of satisfaction, 11 (22%) patients said it was excellent, 27 (54%) patients said it was good, 8 (16%) patients said it was average while 4 (8%) said it was poor. Apgar score for all babies at 1 min and 5 min was very good. It was ≥7 in all 50 (100%) of newborn babies.Conclusions: Epidural labor analgesia gives significantly less pain scores and has better maternal satisfaction. It is not associated with increased rate of instrumental vaginal delivery or cesarean delivery. Patients had excellent neonatal outcome.

scholarly journals Lubricant for Reducing Perineal Trauma: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2022 ◽  
Author(s):  
Qiuyu Yang ◽  
Xiao Cao ◽  
Shasha Hu ◽  
Mingyao Sun ◽  
Honghao Lai ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Vaginal Delivery ◽  
Standard Care ◽  
Meta Analysis ◽  
Perineal Trauma ◽  
Controlled Trials ◽  
Perineal Laceration ◽  
Second Stage ◽  
Randomized Controlled ◽  
Second Stage Labor

Background Different techniques have been reported to prevent perineal lacerations, but the effects of the use of lubricant have been unclear and is still subject of debate. Objective To assess the effect of lubricants on reducing perineal trauma during vaginal delivery. Search strategy PubMed, Embase, the Cochrane Library, CINAHL, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), WanFang databases, ClinicalTrials.gov in 25 June 2021. Selection criteria Randomized controlled trials published in English or Chinese that compared the vaginal application of lubricant with standard care in women with cephalic presentation at vaginal delivery were included . Data collection and analysis Two independent reviewers selected eligible trials and extracted data on perineal trauma, duration of the second-stage labor, postpartum hemorrhage and Apgar score for meta-analysis. Main results Nineteen trials enrolling 5445 pregnant women were included. Compared with standard care, women using lubricants had a lower incidence of perineal trauma (RR 0.84, 95%CI 0.76 to 0.93), second-degree perineal laceration (RR 0.72, 95%CI 0.64 to 0.82) and episiotomy (RR 0.77, 95%CI 0.62 to 0.96), had a shorter duration of the second-stage labor (MD -13.72 minutes, 95%CI -22.68 to -4.77). Subgroup analysis indicated that women with obstetric gel had a shorter duration of the second-stage (MD -16.9 minutes, 95%CI -27.03 to -6.78 vs MD -8.38 minutes, 95%CI -11.11 to -5.65; P interaction=0.02) when compared with liquid wax. Conclusions Compared with standard care, lubricants could reduce the incidence of perineal trauma, especially second-degree perineal laceration, and shorten the duration of the second-stage labor.

Sign in / Sign up

Export Citation Format

Share Document