The effectiveness and acceptability of using a topically applied local anaesthetic to reduce perineal pain during the second stage of labour

2012 ◽  
Author(s):  
Julia Sanders
Keyword(s):  
Local Anaesthetic ◽  
Perineal Pain ◽  
Second Stage ◽  
Second Stage Of Labour

scholarly journals Effect of perineal massage in the second stage of labour, on the incidence of episiotomy and perineal tears

2019 ◽  
Vol 8 (4) ◽  
pp. 1387
Author(s):  
Abinaya Raja ◽  
Pallavee P. ◽  
Rupal Samal
Keyword(s):  
Health Professionals ◽  
Routine Care ◽  
Severe Form ◽  
The Other ◽  
Perineal Pain ◽  
Second Stage ◽  
Perineal Tears ◽  
Second Stage Of Labour ◽  
Perineal Massage

Background: This study aimed to investigate whether perineal massage during second stage of labour could decrease perineal trauma in the form of episiotomy and perineal tears.Methods: One hundred and fifty term antenatal women in labour were randomly assigned to two groups, one of which received perineal massage and the other received routine care during the second stage. Frequency of episiotomies, perineal tears, intact perineums, degrees of perineal tears, duration of second stage of labour and perineal pain after 24 hours was compared.Results: Perineal massage was efficient in reducing incidence of episiotomy, duration of second stage of labour and perineal pain assessed 24 hours after delivery. The frequency of perineal tears and intact perineums did not differ significantly. Perineal massage was protective against severe form of third degree perineal tears.Conclusions: Authors suggest that perineal massage can be routinely practiced by health professionals to improve quality of life in women post vaginal delivery.

scholarly journals Vulvovaginal Infralevator Haematoma Mimicking the Second Stage of Labour

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
J. O. Awoleke ◽  
O. M. Ipinnimo
Keyword(s):  
Blood Loss ◽  
Tissue Damage ◽  
Maternal Morbidity ◽  
Perineal Pain ◽  
Rare Occurrence ◽  
Risk Of Infection ◽  
Final Size ◽  
Rare Presentation ◽  
Second Stage ◽  
Second Stage Of Labour

Even though they are quite uncommon, puerperal genital haematomas can be associated with serious maternal morbidity. Key findings are significant perineal pain and, depending on the location, visible swelling. However, attention can be drawn to its progression by the rare occurrence of persistent painful “bearing down” efforts, even after the successful delivery of the baby. The final size of this haematoma and the rare presentation make it truly uncommon. The primary goals of treatment include the prevention of further blood loss, minimizing tissue damage, relieving pain, and reducing the risk of infection. Management is generally conservative for small collections, but surgery is indispensable when they acutely expand in size or are large with worsening symptoms.

scholarly journals Thyroid storm in the second stage of labour: a case report

2021 ◽  
Vol 14 (7) ◽  
pp. e243159
Author(s):  
Yudianto Budi Saroyo ◽  
Achmad Kemal Harzif ◽  
Beryliana Maya Anisa ◽  
Fistyanisa Elya Charilda
Keyword(s):  
Treatment Guidelines ◽  
Thyroid Storm ◽  
Lung Oedema ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Failure Treatment ◽  
Life Threatening ◽  
Thyroid Hormone Levels ◽  
Peripartum Period ◽  
In Pregnancy

A thyroid storm (or thyroid crisis) is an emergency in endocrinology. It is a form of complication of hyperthyroidism that can be life-threatening. Inadequate control of hyperthyroidism in pregnancy could develop into thyroid storm, especially in the peripartum period. We present a woman came in the second stage of labour, with thyroid storm, superimposed pre-eclampsia, acute lung oedema and impending respiratory failure. Treatment for thyroid storm, pre-eclampsia protocol and corticosteroid was delivered. The baby was born uneventfully, while the mother was discharged after 5 days of hospitalisation. Delivery is an important precipitant in the development of thyroid storm in uncontrolled hyperthyroidism in pregnancy. Although very rare, it can cause severe consequences. Diagnosis and treatment guidelines for thyroid storm were available and should be done aggressively and immediately. Uncontrolled hyperthyroidism should be prevented by adequate control in thyroid hormone levels, especially before the peripartum period.

scholarly journals Clincial Experience with Patient-Controlled and Staff-Administered Intermittent Bolus Epidural Analgesia in Labour

1995 ◽  
Vol 23 (4) ◽  
pp. 459-463 ◽  
Author(s):  
M. J. Paech ◽  
T. J. G. Pavy ◽  
C. Sims ◽  
M. D. Westmore ◽  
J. M. Storey ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Randomized Study ◽  
Obstetric Delivery ◽  
Second Stage ◽  
Intermittent Bolus ◽  
Second Stage Of Labour ◽  
Pain Scores ◽  
Maximum Pain ◽  
Delivery Unit ◽  
Ib Method

A prospective randomized study was Performed to detail clinical experience with both patient-controlled epidural analgesia (PCEA) and midwife-administered intermittent bolus (IB) epidural analgesia during labour, under the conditions pertaining in a busy obstetric delivery unit. Both methods used 0.125% bupivacaine plus fentanyl, and similar rescue supplementation although management decisions related to epidural analgesia were made principally by attending midwives One hundred and ninety-eight women were recruited and data analysed from 167 (PCEA n = 82 IB n=85) The groups were demographically similar. Median hourly pain scores, ratings of analgesia and satisfaction did not differ Maximum pain scores were significantly higher in those receiving IB epidural analgesia (P<0.05). The PCEA group had a significantly higher rate of supplementation and bupivacaine use (P<0.01), and a longer duration of the second stage of labour (P<0.03) The relative risk of instrumental delivery with PCEA versus the IB method was 1.57 (CI 1.07–2.38) Experience within our unit with PCEA is contrasted with that of IB epidural analgesia, the method most commonly used; and with that of controlled trials comparing these two methods.

The quality of intrapartum cardiotocography in preterm labour

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zohal Faiz ◽  
Eline M. Van ’t Hof ◽  
Gerard J. Colenbrander ◽  
Ralf Lippes ◽  
Petra C.A.M. Bakker
Keyword(s):  
Preterm Labour ◽  
Statistical Significance ◽  
International Federation ◽  
Signal Quality ◽  
Foetal Heart Rate ◽  
Signal Loss ◽  
Chi Square ◽  
Second Stage ◽  
Second Stage Of Labour

Abstract Objectives The aim of this study is to determine the quality of the foetal heart rate (FHR) recording, defined as signal loss, during preterm labour below 28 weeks gestational age (GA) and contribute to the discussion if cardiotocography (CTG) is of value for the extreme preterm foetus. Methods From January 2010 to December 2019 a retrospective study was conducted with data of 95 FHR recordings of singletons born between 24 and 28 weeks GA at the Amsterdam University Medical Centre, location VUmc. FHR tracings had a duration of at least 30 min and were obtained via external ultrasound mode. Data of all recordings were divided in two groups according to gestation (24–26 weeks and 26–28 weeks). Signal loss was analysed. Statistical significance was calculated by non-parametric tests and chi-square tests. The median signal loss and the proportion of cases exceeding the International Federation of Gynaecology and Obstetrics Guidelines (FIGO) threshold of 20% signal loss were calculated. Results One-third of the recordings exceeded the 20% FIGO-criterion for adequate signal quality during the first stage of labour. In the second stage, this was nearly 75%. Similarly, the median signal loss was 13% during the first and 30% during the second stage of labour (p<0.01). Conclusions The quality of FHR monitoring in the extreme preterm foetus is inadequate in a large proportion of the foetuses, especially during the second stage. FHR monitoring is therefore controversial and should be used with caution.

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