scholarly journals EPIDURAL ANALGESIA IN LABOUR

2006 ◽  
Vol 13 (03) ◽  
pp. 396-402
Author(s):  
SHAHIDA PARVEEN ◽  
MEHNAAZ KHAKWANI ◽  
HASSAN ZAIDI
Keyword(s):  
Epidural Analgesia ◽  
Anaesthetic Agent ◽  
Effective Means ◽  
Mode Of Delivery ◽  
Great Majority ◽  
Instrumental Delivery ◽  
Unique Problem ◽  
One Year ◽  
Labour Pains ◽  
Fetal Compromise

Introduction: In modern obstetrics, alleviation of labour pains bysimple, safe and effective means presents a unique problem. Epidural analgesia has emerged as a popular andrelatively safe option in this context. It requires injection of local anaesthetic agent into epidural space, which iscommonly approached through lumber intervertebral space. Objective: Aim of study was to determine effect of epiduralanalgesia on progress of labour and mode of delivery, to find out its complications in labour and puerperium and toevaluate neonatal out come in terms of apgar score. Setting: Obstetrics and Gynaecology, Nishtar Hospital, Multan.Period: one year. Material and methods: Sample size: 50 patients. Results: Out of 50 patients, 4 (8%) were below20 years of age, 8 (16%) over 30 years of age and 17(34%) patients were 25-29 years of age. Highest percentage was21-24 years of age i.e. 21(42%) patients. 43 (86%) patients were primi-gravida, 2 (4%) patients had one spontaneousabortion and 5 (10%) patient were second gravida. Three (25%) patients (1-49 with 95% Cl) were induced for PIH withno evidence of coagulopathy and fetal compromise. Fifteen (30%) of patients (14-34 with 95% CI) required noaugmentation with oxytocin. In 29 (58%) of patients although duration less than 8 hours but labour was augmented withsyntocinon. In 2 (11% patients instrumental delivery was performed due to meconium stained liquor and persistentbradycardia. Highest percentage of patients 89% had instrumental delivery because of prolonged second stage.Conclusion: Epidural analgesia provides excellent pain relief in great majority of patients. Maternal fatigue and distresswith all of its ill effects on labour and puerperium is abolished.

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 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 Comparison of Patient-Controlled Epidural Analgesia (PCEA) with Basal Infusion and Programmed Intermittent Epidural Bolus (PIEB) with PCEA in Labour Analgesia – A One-Year Retrospective Study

2021 ◽  
Vol 6 (1) ◽  
pp. 25-31
Author(s):  
Zawiah Kassim ◽  
Arifah Mokthar ◽  
Norliza Mohd Nor ◽  
Suhaina mohamad ◽  
Sarina Osman ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Mode Of Delivery ◽  
Labour Analgesia ◽  
Lower Percentage ◽  
Maternal Satisfaction ◽  
Apgar Scores ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
One Year ◽  
Infusion Regimen

Introduction: For the past thirty years, patient-controlled epidural analgesia (PCEA) with basal infusion regimen has successfully improved the variable intensity of labour pain due to its advantage in allowing self-titration by the parturient. However, a recent review on programmed intermittent epidural bolus (PIEB) with PCEA regimen proved to be superior compared to PCEA with basal infusion, in terms of higher maternal satisfaction with longer duration of analgesia and lower local anaesthetic consumption. Following the introduction of PIEB at our institution, we did a study to compare maternal satisfaction, mode of delivery and neonatal outcome between these two methods of epidural labour analgesia. Methodology: We conducted a one-year retrospective analysis of data from obstetric analgesia service (OAS) record sheet and hospital information system evaluating outcomes after labour analgesia delivered by PCEA with basal infusion regimen (PCEA + basal infusion) and PIEB with PCEA regimen (PIEB+PCEA). The primary outcome was maternal satisfaction towards their labour analgesia. Other outcome parameters were the mode of delivery and neonatal Apgar scores. Outcomes were compared using independent t-test and Chi-square test. Result: There was no significant difference in maternal satisfaction between the two groups (P=0.398). However, a higher percentage of excellent satisfaction was found in the PIEB + PCEA group compared to that in the PCEA + basal infusion group (PIEB+PCEA 146/172 (84.9%) vs PCEA + basal infusion 138/171 (80.7%) respectively). There was no significant difference in the mode of delivery (P=0.296). However, PIEB+PCEA group had a higher percentage of spontaneous vaginal deliveries (PIEB+PCEA 87/172 (50.6%) vs PCEA + basal infusion 70/171 (40.9%) respectively) and a lower percentage of Caesarean deliveries (PIEB + PCEA 71/172 (41.3%) vs PCEA + basal infusion 87/171 (50.9%) respectively). Despite statistically significant differences found in Apgar scores in 1 minute (P=0.036), there was no significant difference in the scores at 5 minutes (P=0.107). Apgar scores and mean (SD) at 1 minute and 5 minutes for PIEB + PCEA were 7.77(0.85) and 8.91(0.55) respectively, and for PCEA + basal infusion the scores at 1 minute and 5 minutes were 7.92(0.39) and 8.98(0.19) respectively. Conclusion: PIEB with PCEA regimen is a newer epidural delivery technique for labour analgesia in our centre, which produced a comparable outcome to PCEA with basal infusion regimen.

scholarly journals Quality of Diet Among Community-Dwelling Elders Participating in the Mobility and Vitality Lifestyle Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 841-841
Author(s):  
Jessica Cheng
Keyword(s):  
Older Adults ◽  
Disease Prevention ◽  
Diet Quality ◽  
Group Intervention ◽  
Health Workers ◽  
Effective Means ◽  
Quality Score ◽  
Community Dwelling ◽  
Total Quality ◽  
One Year

Abstract Dietary choices play an important role in disease prevention both through its effect on weight and independent of it. Improving diet can be an effective means of disease prevention among older adults. Participants (n=303) were recruited from the Allegheny County, PA area and received nutritional education in group sessions led by trained community health workers over one year. Diet quality was captured at baseline and final endpoint (either 9 or 13 months) using the Rate Your Plate (RYP) instrument for assessing healthfulness of diet and includes 24 items that can be summed to generate a total quality score. The mean RYP diet quality score improved from baseline (RYP=50.87) to endpoint (RYP=54.85) (p&lt;.001). Over the course of the intervention, 30.9% of participants made enough improvement in diet to move to a better RYP category. A community-based group intervention for older adults was effective in inducing improvements in diet quality.

scholarly journals An assessment of utilization of postnatal care services in urban area Jabalpur district

2019 ◽  
Vol 6 (9) ◽  
pp. 3660
Author(s):  
Dhruvendra Pandey ◽  
Priyanka Meshram ◽  
Arvind Sharma ◽  
Rajesh Tiwari ◽  
P. K. Kasar
Keyword(s):  
Urban Area ◽  
Urban Areas ◽  
Postnatal Care ◽  
Sampling Method ◽  
Mode Of Delivery ◽  
Great Majority ◽  
Cross Sectional Study ◽  
Postnatal Period ◽  
Cross Sectional ◽  
Early Registration

Background: Postnatal period is a vulnerable time, because most maternal and new born deaths occur during this period, especially immediately after childbirth. Postnatal care in the first hours and days after childbirth could prevent the great majority of these deaths. The objective of study was to assess the utilization of post-natal care and associated factors for low utilization in urban area of Jabalpur district.Methods: A community based cross-sectional study was carried 360 mothers who delivered in last one year in urban area of Jabalpur district. Sampling method was multistage sampling method. A total 36 wards with 10 mothers from each ward was selected. The questionnaire included information related to mode of delivery, post-natal checkups and visits of health care providers.Results: Among 360 mothers, 93.9% mothers received first postnatal check-up within 24 hrs. 1.11% of mothers between 2-3 days and 1.67% of mothers received first postnatal check-up between 4-7 days while 3.33% of mothers didn’t receive any postnatal check-up. Regarding number of post-natal visits, 58.33% mothers received 3 or more postnatal visits, 35% of mother received 2 PNC visits, while 3.3% did not receive a single postnatal visit. The education of mothers, joint type of family, high socioeconomic status, early registration of pregnancy, minimum 4 ANC visits and institutional deliveries were found significantly associated with utilization of postnatal check-up.Conclusions: Utilization of postnatal services is still poor in the urban areas even though the physical accessibility was adequate. In the present study, it was concluded that the role of education, especially of female education, is important contributing factor associated with utilization of postnatal care.

scholarly journals Intrapartum epidural analgesia and emergency delivery rates due to fetal compromise by birth weight percentile

2022 ◽  
Vol 226 (1) ◽  
pp. S583
Author(s):  
Stefanie E. Damhuis ◽  
Henk Groen ◽  
Basky Thilaganathan ◽  
Wessel Ganzevoort ◽  
Sanne J. Gordijn
Keyword(s):  
Birth Weight ◽  
Epidural Analgesia ◽  
Birth Weight Percentile ◽  
Weight Percentile ◽  
Fetal Compromise

scholarly journals Curcumin as an Anticancer Agent in Malignant Mesothelioma: A Review

2020 ◽  
Vol 21 (5) ◽  
pp. 1839 ◽  
Author(s):  
Alfonso Baldi ◽  
Antonio De Luca ◽  
Patrizia Maiorano ◽  
Costantino D’Angelo ◽  
Antonio Giordano
Keyword(s):  
Malignant Mesothelioma ◽  
Anticancer Agent ◽  
Pleural Cavity ◽  
Great Majority ◽  
Review Article ◽  
Clinical Implications ◽  
Tunica Vaginalis ◽  
Pericardial Cavity ◽  
Anti Cancer ◽  
One Year

Malignant mesothelioma is an infrequent tumor that initiates from the mesothelial cells lining of body cavities. The great majority of mesotheliomas originate in the pleural cavity, while the remaining cases initiate in the peritoneal cavity, in the pericardial cavity or on the tunica vaginalis. Usually, mesotheliomas grow in a diffuse pattern and tend to enclose and compress the organs in the various body cavities. Mesothelioma incidence is increasing worldwide and still today, the prognosis is very poor, with a reported median survival of approximately one year from presentation. Thus, the development of alternative and more effective therapies is currently an urgent requirement. The aim of this review article was to describe recent findings about the anti-cancer activity of curcumin and some of its derivatives on mesotheliomas. The potential clinical implications of these findings are discussed.

scholarly journals Epidural analgesia during labour: its influences on pain relief, progress of labour, mode of delivery, maternal and foetal

2020 ◽  
Vol 9 (2) ◽  
pp. 555
Author(s):  
M. Suneetha ◽  
A. Saritha
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Control Group ◽  
Sitting Position ◽  
Tertiary Care Centre ◽  
Group 2

Background: Today, the availability of regional anaesthesia for labour is considered a reflection of standard obstetric care. This study is to be conducted in a tertiary care centre with all facilities available for proposed end of proving that epidural analgesia is a safe and effective method for both parturient and the foetus in abolishing pain during labour.Methods: A total of 60 parturients were studied. they were randomly divided into two groups Group 1 includes 30 parturients. In this group parturient received epidural analgesia. The loading dose consisted of 10 ml of Bupivacaine 0.1% and Fentanyl 0.0002% (20 mcg). The top up doses were 10 ml of 0.1% Bupivacaine and Fentanyl 0.0002%, administered whenever the parturient complained of pain. When parturients enters into second stage a further 12-15 ml was injected with parturient in sitting position or semi-sitting position. Group 2 - (control group) Includes 30 parturients. In this group parturient was monitored without any analgesia.Results: This prospective study was done to assess the effect of epidural analgesia on the progress of labour and its outcome, to evaluate its efficacy as an analgesic technique and to study the maternal and fetal outcome. The total number of 60 parturients were selected and randomly categorized into two groups. CASE-Those who received epidural analgesia, CONTROL-Those who did not receive any analgesia.Conclusions: Epidural analgesia provides a versatile method of administering effective and satisfactory pain relief to parturient women. The technique should not be considered as a single entity, because the type and the dose of epidural medication can be altered as needed.

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