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Background: Labor pain is one of the most excruciatingly painful sensations a woman can have. A woman's attitude toward childbirth might be influenced by her lack of understanding of the birth process and the pain she experiences throughout labor and delivery. The control of pain is an important aspect of appropriate obstetrical care. Our study aims to measure the level of awareness, preconception, and fear of epidural analgesia (EDA) among childbearing women. Methods: An observational cross-sectional, hospital-based study was conducted using a self-administered questionnaire. The study included all pregnant women who were attending an obstetrical clinic for routine antenatal follow-up at King Khalid university hospital in Riyadh, Saudi Arabia, during the month of August 2022. They were asked about five main parts that tapped their awareness, preconception, and fear of EDA. Data were analyzed by SPSS version 26 using descriptive methods, including mean, frequency, and percentage, and also Pearson's correlation coefficient for regression analysis to find the correlation between socio-demographics and awareness and between awareness and fear. Results: Participants in our study included 202 childbearing women. Most women, about 113 (55.9%), participating in the study were aged between 25 and 34 years old. The majority of the participants of this study were Saudi, about 196 (97.0%). In terms of education, 120 (59.4%) of the participants graduated from university. One hundred and forty two (70.3%) of the participants had a monthly income of less than 10000. When it comes to parity, the majority of participants, about 102 (50.5%), have had more than two pregnancies. The average percentage of awareness among the participants showed 45.9%, with an insignificant very moderate correlation between parity and awareness (r = -0.088, P = 0.107); women's knowledge, income, and age were also insignificantly related to awareness. Also, the result showed a moderate level of fear with an average percentage of 44.6% among the participants, with a moderate correlation between awareness and fear with a value of (r = 0.184, P = 0.004). Conclusion: This study results demonstrate a good level of desirability toward using EDA for labor pain, yet there is a limited level of preconceptions and a low level of awareness and knowledge about EDA. In addition, the results showed that the average percentage of fear is 44.6%. Therefore, we suggest that more awareness, knowledge, and guidance about EDA should be provided to pregnant women through antenatal clinics. Furthermore, educational campaigns should be made to dispel misconceptions and fears about EDA.
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[This retracts the article DOI: 10.7759/cureus.18887.].
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BACKGROUND: Coagulopathy is a well-recognized complication in patients with coronavirus disease 2019 (COVID-19). Pulmonary embolism (PE) has substantial morbidity and mortality if the diagnosis is missed or the management is delayed. Computed tomography pulmonary angiography (CT-PA) is the imaging modality of choice for PE. Therefore, this study aimed to investigate the positive rate of CT-PA for PE among patients with COVID-19. METHODS: We conducted a retrospective study examining the diagnostic yield of CT-PA in patients with confirmed COVID-19 and compared it with that in patients without COVID-19. The study included all adult patients with confirmed COVID-19 who presented from June 2020 to June 2021. RESULTS: The study included 316 patients, including 158 patients with COVID-19, who underwent CT-PA for ruling out PE. Overall, 76 patients were found to have PE on the CT-PA scan, yielding a positive rate of 24.1%, with a significant difference between patients with COVID-19 (8.2%) and those without COVID-19 (39.9%). Further, 138 (87.3%) patients with COVID-19 had elevated D-dimer levels compared with 34 (21.5%) patients without COVID-19. A multivariable regression analysis model revealed that the smoking status (odds ratio [OR] = 1.94; 95% confidence interval [CI]: 1.4-3.8) and obesity (OR = 4.1; 95% CI: 1.5-8.9) were independent predictors of PE among patients with COVID-19. However, the elevated D-dimer level was not significantly associated with PE among patients with COVID-19 (OR = 0.7; 95% CI: 0.4-1.8). CONCLUSION: The study found that the positive rate of CT-PA for PE was lower among patients with PE indicating probable overutilization of investigation in these patients. Additionally, patients with COVID-19 had a higher proportion of elevated D-dimer levels that may be a contributor to the increased investigation for PE. Lastly, patients with COVID-19 who were current smokers had a higher tendency of having PE.