Comparison of continuous infusion versus midwife administered top-ups of epidural bupivacaine for labour analgesia: effect on second stage of labour and mode of delivery

2003 ◽  
Vol 12 (1) ◽  
pp. 9-11 ◽  
Author(s):  
T.S. Usha Kiran ◽  
M.B. Thakur ◽  
J.A. Bethel ◽  
P.S. Bhal ◽  
R.E. Collis
Keyword(s):  
Continuous Infusion ◽  
Mode Of Delivery ◽  
Labour Analgesia ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Epidural Bupivacaine

scholarly journals LABOUR ANALGESIA BY NEUROAXIAL BLOCKADE TECHNIQUE AND ITS LABOUR OUTCOME

2021 ◽  
pp. 10-13
Author(s):  
R.Shanthi Malar ◽  
V. Vijayalakshmi ◽  
P. Thenmozhi
Keyword(s):  
Epidural Analgesia ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fold Increase ◽  
Study Groups ◽  
Labour Analgesia ◽  
Control Group ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Significant Difference

BACKGROUND:Pain relief during labour is an important component of modern obstetric care and can be produced by neuraxial, systemic or inhalational analgesia. Recent meta-analyses have supported epidural analgesia as the most efficacious technique.A good labour analgesia should aim at good pain relief during delivery process,at the same time not causing foetal acidosis,ensures safe for both mother and the baby. AIM OF THE STUDY:To study the influence of epidural analgesia on maternal and neonatal outcome MATERIALS AND METHODS:The study was conducted in the depar tment of Obstet r ics and Gynecology,GOVT.Stanley Medical College,Govt.RSRM LYING IN HOSPITAL,CHENNAI over a period of eight months from July 2019 to February 2021. The study was performed in 120 selected subjects. The study subjects were divided based on intervention – labour analgesia into 2 study groups. In this study,change in vital parameters,fetal heart rate,assessment of pain score,Duration of first and second stage of labour,mode of delivery,APGAR score and the need for NICU admission were noted and recorded.Any complications during the course of labour were also recorded. RESULTS:In this study,there was no significant difference in the mean duration of first and second stage of labour in both the study and control groups.The mean Apgar score of babies at one minute was 7.02 and at 5 minutes was 8.07 in the labour analgesia group and showed no significance.Maternal satisfaction for the effect of epidural analgesia,60.00% of the patients of epidural analgesia, the incidence of satisfactory/very satisfactory experience was meaningfully and significantly more in labour analgesia group subjects compared to control group subjects by 30 % with a 2 fold increase. CONCLUSION: As per this study labour analgesia using neuroaxial blockade technique are more likely to encounter increasing maternal satisfaction and good quality labour pain reduction.

scholarly journals Upright kneeling position during second stage of labor: a pilot study

2018 ◽  
Vol 7 (2) ◽  
pp. 401 ◽  
Author(s):  
Anjali Dabral ◽  
Pallavi Pawar ◽  
Rekha Bharti ◽  
Archana Kumari ◽  
Achla Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Admission Rate ◽  
North India ◽  
Care Hospital ◽  
Apgar Scores ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Perineal Tears ◽  
Second Stage Of Labour

Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients’ satisfaction.Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction.Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position.Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.

scholarly journals Labour with low dose epidural analgesia: maternal perception and fetal outcome

2018 ◽  
Vol 7 (2) ◽  
pp. 689 ◽  
Author(s):  
Vasudha Sawant ◽  
Archana Kumbhar
Keyword(s):  
Epidural Analgesia ◽  
Apgar Score ◽  
Low Dose ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Natural Phenomenon ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Significant Difference ◽  
Vertex Presentation

Background: Experiencing labour pains and giving birth to infant is normal physiological process. Though it is a natural phenomenon, it produces severe pain which requires analgesia to relieve pain during labour. The objective of this study was to compare effects of low dose epidural analgesia verses no analgesia during labour on mother and fetus.Methods: Here in this study we have assessed effect of epidural analgesia on mother and fetus. Total we have taken 60 women in age group of 20-26 years with full term pregnancy (37-42 weeks). Those who have entered spontaneous labour with vertex presentation, without any previous uterine surgery, clinically adequate pelvis. We had divided these women in 2 groups, 30 were given epidural analgesia and 30 without any analgesia. Variables recorded were pain score during labour using VAS, duration of labour during each stage, mode of delivery, Apgar score of newborn at 1 minute and 5 minutes.Results: Present study shows that duration of first stage of labour in epidural and non-analgesia group are same. Second stage of labour is prolonged in epidural group than non-analgesia group. Both groups had normal APGAR score. Epidural analgesia is not associated with any change in mode of delivery. Visual analogue scale is good with epidural analgesia.Conclusions: There was no significant difference in first stage of labour in both group. Second stage of labour was slightly prolonged in EA group than control, but it was less than two hours. No harmful neonatal outcome in epidural analgesia.

scholarly journals P04.09: Intrapartum ultrasound and mode of delivery in prolonged second stage of labour

2017 ◽  
Vol 50 ◽  
pp. 164-165
Author(s):  
A. Dall'Asta ◽  
I. Lauriola ◽  
A. Kiener ◽  
S. Politi ◽  
T. Frusca ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Second Stage ◽  
Second Stage Of Labour

A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor

2015 ◽  
Vol 122 (1) ◽  
pp. 172-177 ◽  
Author(s):  
Margaret G. Craig ◽  
Erica N. Grant ◽  
Weike Tao ◽  
Donald D. McIntire ◽  
Kenneth J. Leveno
Keyword(s):  
Mode Of Delivery ◽  
Group Versus ◽  
Postnatal Period ◽  
Neonatal Outcomes ◽  
Motor Blockade ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
Epidural Bupivacaine ◽  
Second Stage Labor

Abstract Background: The purpose of this prospective, double-blinded, parallel-arm, randomized trial was to examine the effects of epidural bupivacaine on the length of the second stage of labor in nulliparous women. Methods: The authors assessed length of second-stage labor, degree of motor blockade, mode of delivery, and visual analog scores in 310 nulliparous women with labor epidurals randomized to receive either: (1) 0.125% bupivacaine and fentanyl 2 μg/ml or (2) fentanyl 10 μg/ml alone via epidural using double blinding. Results: The median duration of the second stage was 75 min (41, 128) in the bupivacaine/fentanyl group versus 73 min (42, 120) in the fentanyl-only group (P = 0.17) with a median difference of 6.0 (95% CI, −6.0 to 18.0). Furthermore, there was no difference in degree of motor blockade, incidence of operative delivery, visual analog scores, or neonatal outcomes between the two groups. No adverse events were reported. Conclusions: Use of epidural bupivacaine/fentanyl or a fentanyl-only infusion during the second stage of labor did not affect the duration of the second stage of labor, degree of motor blockade, mode of delivery, pain relief, and maternal or neonatal outcomes. However, in the fentanyl-only infusion group, there was a fivefold increase in opioid exposure to the fetus with unknown effects on neurobehavior, an outcome not assessed beyond the immediate postnatal period in this study.

scholarly journals OP13.11: Transabdominal and transperineal intrapartum ultrasound and mode of delivery in prolonged second stage of labour

2018 ◽  
Vol 52 ◽  
pp. 104-104
Author(s):  
A. Dall'Asta ◽  
N. Volpe ◽  
G. Schera ◽  
A. Kiener ◽  
L. Galli ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Second Stage ◽  
Second Stage Of Labour

scholarly journals Association between first and second stage of labour duration and mode of delivery: A population‐based cohort study

2021 ◽  
Author(s):  
Louise Lundborg ◽  
Katarina Åberg ◽  
Anna Sandström ◽  
Xingrong Liu ◽  
Ellen Tilden ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mode Of Delivery ◽  
Population Based ◽  
Second Stage ◽  
Second Stage Of Labour

scholarly journals Cesarean Section or Instrumental Delivery: The Best Choice for Mode of Delivery during Second Stage of Labor

2020 ◽  
Vol 42 (2) ◽  
pp. 42-46
Author(s):  
Suniti Rawal ◽  
Neeta Katuwal ◽  
Sajana Shrestha
Keyword(s):  
Cesarean Section ◽  
Teenage Pregnancy ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Instrumental Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Emergency Cesarean ◽  
Associated Risk Factors

Introduction Managing second stage of labour is very crucial. Emergency Cesarean Section (CS) or Instrumental Delivery (ID) is the only choices although complications might occur in both modes of deliveries. The rate of CS is at rise and the fear of failed ID followed by emergency CS with added complications makes the choice more difficult amongst the obstetricians. MethodsA retrospective study done to assess the maternal and fetal outcome in second stage of labour following ID and emergency CS from April 2018 to March 2019 among the pregnant women having completed 34 weeks of gestations and beyond. ResultsOf 4761 deliveries, 2537 (53.2%) were vaginal and 2224 (46.7%) CS, and amongst all, 133 (2.7%) were second stage interventions. Out of 133, 78 had ID, 76 were successful and 2 failed. Fifty seven (2.6%) were second stage CS. Nulliparas (65.8%) needed more ID, teenage pregnancy (6.5%) (p=0.04) and heart disease (18.4%) (p=0.002) were high risk for ID. Complications were more in CS, uterine extensions, (29.8%) (p<0.001), urinary complications, (43.9%) (p<0.001) and blood loss (p<0.001). Neonatal admission too was higher in CS (n=29) and more so due to respiratory distress (16/29). ConclusionDespite of few failed attempted ID, it still proved to be better choice for delivery during second stage, as both maternal and neonatal complications were higher following the second stage CS. Hence, the correct and timely decision for ID addressing the associated risk factors could lead to favorable outcome.

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