scholarly journals Labor pain relief and postpartum depression. Is there a correlation?

2017 ◽  
Vol 66 (5) ◽  
pp. 11-20 ◽  
Author(s):  
Oksana V. Riazanova ◽  
Yury S. Aleksandrovich ◽  
Vitaly A. Reznik ◽  
Irina A. Gorkovaya ◽  
Maria A. Korgozha ◽  
...  
Keyword(s):  
Pain Relief ◽  
Postpartum Depression ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Local Anesthetic ◽  
Pain Syndrome ◽  
Vaginal Birth ◽  
Labor Pain ◽  
Gestation Period ◽  
Ropivacaine Hydrochloride

The article is dedicated to the evaluation of the effect of labor pain relief by using epidural analgesia during vaginal delivery on the frequency of postpartum depression. Materials and methods. 159 women were included in the study. The average age of the patients was 29 years, the average gestation period was 39.7 weeks. In the first group, in order to relief the pain while vaginal birth, an epidural analgesia was administered. A continuous patient-controlled infusion was used along with 0.08% solution of ropivacaine hydrochloride in the capacity of a local anesthetic. Patients of the second group gave birth without any anesthesia. Evaluation of the depression progress was carried out several times: before birth, 6 hours after delivery, 3 days and 6 weeks after delivery. Results of the study. Usage of epidural analgesia during vaginal delivery leads to a significant pain syndrome relief, but does not reduce the probably of postpartum depression.

Relationship between painless delivery and postpartum depression: The Japan Environment and Children’s Study (JECS)

2021 ◽  
Author(s):  
Nobuhiro Suzumori ◽  
Takeshi Ebara ◽  
Hazuki Tamada ◽  
Taro Matsuki ◽  
Hirotaka Sato ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Cesarean Section ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
First Trimester ◽  
Regression Analyses ◽  
One Year ◽  
Spinal Epidural ◽  
Paracervical Block

Abstract Background Postpartum depression is one of the most commonly experienced psychological disorders for women after childbirth, usually occurring within one year. This study aimed to clarify whether women with painless delivery, including epidural analgesia, spinal-epidural analgesia, and paracervical block, had a decreased risk of postpartum depression after giving birth in Japan. Methods The Japan Environment and Children’s Study (JECS) was a prospective cohort study that enrolled registered fetal records (n = 104,065) in 15 regions nationwide in Japan. Binomial logistic regression analyses were performed to calculate the adjusted odd ratios (aORs) for the association between mode of delivery with or without analgesia and postpartum depression at one-, six- and twelve-months after childbirth. Results At six months after childbirth, painless vaginal delivery was associated with a higher risk of postpartum depression (aOR: 1.218, 95% confidence interval: 1.067–1.391), compared with vaginal delivery without analgesia or cesarean section. Nevertheless, the risk disappeared one year after delivery. Among the pregnant women who requested painless delivery, 5.1% had a positive Kessler-6 scale (K6) score for depression before the first trimester (p < 0.0001), which was significantly higher than the proportions in the vaginal delivery without analgesia (3.5%) and cesarean delivery (3.5%) groups. Conclusions Our data suggested that the risk of postpartum depression at six months after childbirth tended to be increased after painless vaginal delivery, compared with vaginal delivery without analgesia or cesarean section. Requests for painless delivery continue to be relatively uncommon in Japan, and women who make such requests might be more likely to experience postpartum depressive symptoms because of underlying personality characteristics, including a tendency to worry.

scholarly journals Development of the Labor Pain Relief Attitude Questionnaire for Pregnant Women (LPRAQ-p)

2020 ◽  
Author(s):  
Lianne P Hulsbosch ◽  
Ivan Nyklíček ◽  
Eva S Potharst ◽  
Myrthe GBM Boekhorst ◽  
Victor JM Pop
Keyword(s):  
Factor Analysis ◽  
Pain Relief ◽  
Confirmatory Factor Analysis ◽  
Epidural Analgesia ◽  
Pregnant Women ◽  
Labor Pain ◽  
Attitude Questionnaire ◽  
Distress Symptoms ◽  
Confirmatory Factor ◽  
Explorative Factor Analysis

Abstract Background: Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p).Methods: Three focus group interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432).Results: The explorative factor analysis suggested a two-factor seven-item solution: a ‘women’s perception’ and ‘social environment’ subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Higher scores on the six-item LPRAQ-p indicate greater willingness for request of pain relief medication during labor. Two-tailed t-tests showed that women with elevated levels of depression and pregnancy-specific distress symptoms, nulliparous women and multiparous women with complications during previous delivery had greater willingness for request of pain relief medication during labor. Linear regression showed that the most important association with higher scores on the LPRAQ-p were high pregnancy-specific distress symptoms.Conclusions: This study showed the LPRAQ-p to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. High scores on this questionnaire are associated with high levels of pregnancy-specific distress symptoms.

PATIENT CONTROLLED EPIDURAL ANALGESIA versus CONTINUOUS INFUSION FOR LABOR PAIN RELIEF

1998 ◽  
Vol 86 (Supplement) ◽  
pp. 371S
Author(s):  
Susan Harke ◽  
Gordon Mandell ◽  
Sivam Ramanathan
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Continuous Infusion ◽  
Labor Pain

scholarly journals Epidural analgesia in labor: specific characteristics, dilemmas and controversies

2012 ◽  
Vol 65 (9-10) ◽  
pp. 441-447 ◽  
Author(s):  
Marija Kutlesic ◽  
Ranko Kutlesic
Keyword(s):  
Blood Flow ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Epidural Block ◽  
Labor Pain ◽  
Active Management ◽  
Delivery Rate ◽  
Epidural Puncture ◽  
Small Doses ◽  
Uteroplacental Blood Flow

Introduction. Epidural analgesia has become the most popular method for labor pain relief. Analgesia in Labor: Yes or No? Labor pain is a complex phenomenon with sensory, cognitive, motivational, emotional, social, and cultural variables. Pain and anxiety lead to adrenergic hyperactivity, hyperventilation, hypocapnia with reduced uteroplacental blood flow and uncoordinated uterine activity, so pain relief is recommended and even indicated in cases of maternal comorbidity. Analgesia in Labor: Method of Choice. The quality of epidural analgesia is better than the one achieved by parenteral or inhalation agents, with increased uteroplacental blood flow and improved fetal-maternal oxygenation. Epidural Analgesia in Labor: What is Specific? The increased weight, lumbar lordosis, soft tissue edema and engorgement of epidural veins make it more difficult to perform epidural block in pregnancy. Epidural puncture should be performed by medial approach, at L2 - 3 or L3 - 4 level by loss of resistance technique between contractions. Epidural Analgesia in Labor: What With? Local anesthetics, bupivacaine, levobupivacaine, ropivacaine, are used and they can be combined with small doses of opioids (fentanyl or sufentanyl). Epidural Analgesia in Labor: How? Available techniques are epidural, spinal and combined spinal - epidural analgesia. Epidural Analgesia in Labor: Controversies. The most important controversy is the influence of epidural analgesia on operative or instrumental delivery rate. Low concentrations of local anesthetic in combination with small doses of opioids, together with active management of labor by an obstetrician, would lead to increased spontaneous delivery rate. Conclusion. Although there still are some difficulties, complications and controversies, epidural analgesia provides safe and effective labor pain control.

scholarly journals Relationship between delivery with anesthesia and postpartum depression: The Japan Environment and Children’s Study (JECS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nobuhiro Suzumori ◽  
Takeshi Ebara ◽  
Hazuki Tamada ◽  
Taro Matsuki ◽  
Hirotaka Sato ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
First Trimester ◽  
Regression Analyses ◽  
Postpartum Depressive Symptoms ◽  
One Year ◽  
Spinal Epidural ◽  
Paracervical Block

Abstract Background Postpartum depression is one of the most commonly experienced psychological disorders for women after childbirth, usually occurring within one year. This study aimed to clarify whether women with delivery with anesthesia, including epidural analgesia, spinal-epidural analgesia, and paracervical block, had a decreased risk of postpartum depression after giving birth in Japan. Methods The Japan Environment and Children’s Study (JECS) was a prospective cohort study that enrolled registered fetal records (n = 104,065) in 15 regions nationwide in Japan. Binomial logistic regression analyses were performed to calculate the adjusted odd ratios (aORs) for the association between mode of delivery with or without anesthesia and postpartum depression at one-, six- and twelve-months after childbirth. Results At six months after childbirth, vaginal delivery with anesthesia was associated with a higher risk of postpartum depression (aOR: 1.233, 95% confidence interval: 1.079–1.409), compared with vaginal delivery without analgesia. Nevertheless, the risk dropped off one year after delivery. Among the pregnant women who requested delivery with anesthesia, 5.1% had a positive Kessler-6 scale (K6) score for depression before the first trimester (p < 0.001), which was significantly higher than the proportions in the vaginal delivery without analgesia (3.5%). Conclusions Our data suggested that the risk of postpartum depression at six months after childbirth tended to be increased after vaginal delivery with anesthesia, compared with vaginal delivery without analgesia. Requests for delivery with anesthesia continue to be relatively uncommon in Japan, and women who make such requests might be more likely to experience postpartum depressive symptoms because of underlying maternal environmental statuses.

scholarly journals EPIDURAL ANALGESIA DURING VAGINAL DELIVERY AT THE WOMEN WITH THE UTERINE SCAR. IS IT RISKY? POSSIBLE? NECESSARY?

2017 ◽  
Vol 11 (3) ◽  
pp. 182-188
Author(s):  
K. A Bozhenkov ◽  
T. A Gustovarova ◽  
A. N Ivanyan ◽  
V. L Vinogradov ◽  
E. M Shifman
Keyword(s):  
Cesarean Section ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Total Duration ◽  
Perinatal Outcomes ◽  
Pain Syndrome ◽  
Comparative Assessment ◽  
Group A ◽  
Uterine Scar ◽  
Group B

This paper will be concerned with the results of a prospective controlled longitudinal study which has involved 132 secundiparae (among them 69 patients are with the uterine scar after cesarean section). The parturient women have been divided into 3 groups. Group “A” includes 38 women with the uterine scar after cesarean section, in this group epidural analgesia was administered during vaginal delivery. Group “B” includes 32 secundiparae without uterine scar, in this group epidural analgesia was administered during vaginal delivery. Group “C” - 31 women with the uterine scar, no epidural analgesia was administered during vaginal delivery. Based on a comparative assessment of the pain syndrome intensity in labor according to the visual analogue scale, the research has proved that delivery at the women with the uterine scar is accompanied by statistically more significant pain than at the women without uterine scar. The necessity of analgesia during vaginal delivery at the women with the uterine scar has been proved. The effectiveness and safety of epidural analgesia at patients with the uterine scar have been analyzed. It has been proved that epidural analgesia provides anesthesia during vaginal delivery at the women with the uterine scar, while it does not affect the total duration and course of labor, maternal and perinatal outcomes, and does not mask the clinical picture of the uterine rupture threat.

scholarly journals Manejo não farmacológico de alívio da dor em partos assistidos por enfermeira obstétrica

2017 ◽  
Vol 11 (12) ◽  
pp. 4929 ◽  
Author(s):  
Danielle Lehugeur ◽  
Márcia Rejane Strapasson ◽  
Edegar Fronza
Keyword(s):  
Retrospective Study ◽  
Pain Relief ◽  
Data Collection ◽  
Vaginal Delivery ◽  
Labor Pain ◽  
Pharmacological Management ◽  
Natural Childbirth ◽  
Pharmacological Method ◽  
Process Method ◽  
Program Version

RESUMO Objetivo: caracterizar os partos assistidos por enfermeira obstétrica quanto aos métodos não farmacológicos de alívio da dor no processo de parturição. Método: estudo quantitativo, transversal, descritivo e retrospectivo com 232 prontuários de parturientes com parto vaginal assistido por enfermeira obstétrica. A coleta das informações foi realizada em prontuários de pacientes, e os dados foram analisados usando o programa SPSS, versão 21.0, sendo apresentados em uma figura e quatro tabelas. Resultados: 98,3% utilizaram algum método não farmacológico de alívio da dor, a saber: deambulação (79,2%), banho (73,1%), massagem (60,0%), variedade de posição (58,8%), aromaterapia (46,9%), bola (42%), entre outros. Conclusão: novos estudos podem ser realizados com enfoque na eficácia do manejo não farmacológico da dor no processo de parturição. Descritores: Parto Normal; Dor; Dor do Parto; Enfermagem Obstétrica.ABSTRACTObjective: to characterize a delivery assisted by an obstetric nurse regarding non-pharmacological methods of pain relief in the parturition process. Method: this is a quantitative, transversal, descriptive, retrospective study with 232 records of parturients with vaginal delivery assisted by an obstetric nurse. Data collection was carried out in patients' records and data analyzed using the SPSS Program version 21.0, presented in figures and tables. Results: there were 98.3% of patients using some non-pharmacological method of pain relief, such as: ambulation (79.2%), bath (73.1%), massage (60.0%), position variety (58.8%), aromatherapy (46.9%), ball (42%), among others. Conclusion: new studies can be performed focusing on the efficacy of non-pharmacological management of pain in the parturition process. Descriptors: Natural Childbirth; Pain; Labor Pain; Obstetric Nursing.RESUMENObjetivo: caracterizar a los partos asistidos por uma enfermera obstétrica sobre los métodos no farmacológicos de alivio del dolor, en el proceso de parturición. Método: estudio cuantitativo, transversal, descriptivo, retrospectivo con 232 prontuarios de parturientes con parto vaginal asistido por uma enfermera obstétrica. La recolección de las informaciones fue realizada en prontuarios de pacientes y los datos analizados usando el Programa SPSS versión 21.0, presentados en figura y tablas. Resultados: 98,3% utilizaron algún método no farmacológico de alivio del dolor, entre ellos: deambulación (79,2%), baño (73,1%), masaje (60,0%), variedad de posición (58,8%), aromaterapia (46,9%), bola (42%), entre otros. Conclusión: nuevos estudios pueden ser realizados con enfoque en la eficacia del manejo no farmacológico del dolor, en el proceso de parturición. Descriptors: Parto Normal; Dolor; Dolor de Parto; Enfermería Obstétrica.

scholarly journals LABOR ANALGESIA IN KIEV (UKRAINE)

2021 ◽  
pp. 39-46
Author(s):  
I. Kuchyn ◽  
D. Govsieiev ◽  
K. Bielka ◽  
A. Romanenko
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Local Level ◽  
The United States ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Maternity Hospitals ◽  
Quality Of Medical Care ◽  
Pharmacological Method ◽  
The Uk

The problem of a labor pain is becoming very important for health care because insufficient analgesia for women during childbirth affects the quality of medical care. The complexity of the use in the system and approaches to providing care to citizens in Ukraine, and at the local level –  the interaction of the obstetrician with the women, anaesthetist and also the technical capabilities of public maternity hospitals [1]. For the last decade, epidural analgesia has been the «golden» method in labor analgesia. We searched numerous meta-analyzes about pain management during labor and delivery in the United States, they prefer epidural analgesia in 80-90% of women, while in the UK - 36% [2, 3]. Statistics from around the world indicate a relationship between pain relief and income levels, so in high-income countries, (HICs) women are more likely to be anesthetized during childbirth than in South Africa or Asia [4]. Although childbirth is a physiological and natural process, it needs pain relief. Nowadays a woman’s desire is a sufficient indication for labor analgesia, and this is her right [5]. The problem is to choose a pharmacological and / or non-pharmacological method of analgesia for a particular woman, which will be best for the parturient. It should be noted that there is a separate group of women who choose to give birth at home to reduce the «aggression» of medical staff against women and her child, but they have a higher incidence of complications and increased mortality [6]. «Homebirth» in maternity hospitals helps to solve this problem. A comprehensive questionnaire was created among seven state maternity hospitals in Kyiv to identify the current situation with the provision of maternity care and to analyze the main issues of labor analgesia in Kyiv.

scholarly journals Labour Analgesia When Epidural Is Not a Choice: Tramadol versus Pentazocine

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Jyothi Shetty ◽  
Ashwini Vishalakshi ◽  
Deeksha Pandey
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Labor Pain ◽  
Resource Poor Setting ◽  
Analog Scale ◽  
The World ◽  
Resource Poor ◽  
The Given ◽  
First Stage Of Labor

Background. Parenteral opioids, thus, are still popular for pain relief in labor in many countries throughout the world. Aim. To evaluate and compare the efficacy of intramuscular tramadol and pentazocine in the first stage of labor. Method. Sixty-five patients were divided into pentazocine group and tramadol group. Subjects received either 30 mg pentazocine or 1 mg/kg tramadol intramuscularly. Pain was assessed using visual analog scale (VAS) before the administration of the drug, at 1 h, 2 h, 4 h, and at full dilatation. Maternal and neonatal side effects were determined. Results. Analgesic effect of the two drugs was not significantly different. Neither of these analgesics was effective towards the end of the first stage. However, in the tramadol group, the majority of women (55%) rated pain as severe, whereas in the pentazocine group, the majority of women (60%) rated pain as moderately severe. There were not many side effects with either of the drug in the given dosage. Mean injection to delivery interval was significantly shorter in the tramadol group as compared to the pentazocine group. Conclusion. Pentazocine or tramadol can be given for labor pain relief as an alternative to epidural analgesia in resource poor setting.

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