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1.
Niger J Clin Pract ; 24(11): 1624-1632, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34782500

RESUMO

Background: Intrapartum professional midwifery support can improve the coping skills with the fear of childbirth and birth pain, increase the perception of the woman, and prevent negative experiences. However, there are relatively few studies supporting this postulation. Aims: To investigate the effects of supportive care given during labor on birth pain, birth fear, perception of midwifery care, oxytocin use, and delivery time. Patients and Methods: This is a quasi-experimental study. We collected the data between January and June 2019 in a province in Central Anatolia, Turkey. Primiparous 102 pregnant women were included in the study. However, we excluded five pregnant women from the intervention group and four pregnant women from the control group as emergency cesarean section developed. In total, 93 pregnant women, 46 in the continuous supportive care intervention group, and 47 in the usual intrapartum care control group were evaluated. The following tools were used to collect data: The Delivery Fear Scale, a Visual Analog Scale for perceived pain, the Scale of Women's Perception for Supportive Care Given During Labor, and labor outcomes information form. Results: The participants in the intervention group receiving continuous intrapartum supportive care had less fear of birth and lower birth pain in the active and transitional stages of labor, their midwifery care perception increased, and the duration of labor was shorter (P < 0.05). However, there was no significant difference in oxytocin use between the two groups at 95% confidence interval (-0.265-0.091) (p > 0.05, Cohen's d = 0.2). Conclusion: Pregnant women who received continuous intrapartum supportive care had less fear of birth and reduced labor pain in active and transitional stages of labor. In addition, with the continuous supportive care provided, the perception of midwifery care of the pregnant women increased and the duration of labor decreased. Therefore, midwifery care support should be provided to women throughout their labor and delivery process.


Assuntos
Dor do Parto , Trabalho de Parto , Tocologia , Cesárea , Parto Obstétrico , Medo , Feminino , Humanos , Dor do Parto/tratamento farmacológico , Ocitocina , Percepção , Gravidez
2.
Rev Bras Enferm ; 74(suppl 6): e20210079, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34431929

RESUMO

OBJECTIVES: to assess the effects of floral therapy in the face of factors that boost pain in the parturition process and its results in the duration of labor. METHODS: this is a randomized, controlled and triple-blind clinical trial. We selected 164 pregnant women with gestational age ≥37 weeks, cervical dilation ≥4 cm, randomly divided into floral therapy and placebo group. RESULTS: the Five Flower floral essence proved to be effective, considering the factors that boost pain in labor. Experimental Group did not show an increase in contractions, unlike Control Group, which presented an increase of one contraction for mothers in active phase and amniorrhexis. The Five Flower essence proved to be effective in reducing labor time by 1:30h from the beginning of the intervention at birth. CONCLUSIONS: floral therapy proved to be effective in pain management, reflecting positively in its brevity, qualifying its outcome.


Assuntos
Dor do Parto , Trabalho de Parto , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Manejo da Dor , Parto , Gravidez
3.
J Obstet Gynaecol Res ; 47(11): 3857-3866, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34374177

RESUMO

AIM: Vitamin D has widespread receptor distribution in the body, and therefore it has vital roles in numerous pathophysiological conditions. It also affects pain manifestation through its functions at various stages of the pain pathways. This study aimed to investigate the effects of intrapartum vitamin D levels on pain experienced by women during the first stage of labor. METHODS: A total of 127 term-nulliparous women at the early stage of labor were included in the study. Serum 25 (OH) vitamin D levels were measured at the beginning of labor to determine intrapartum vitamin D levels. Labor pain was assessed using the Visual Analog Scale at different stages of cervical dilation (VAS0 , VAS1 , VAS2 ). Postpartum pain (VASpp ) and women's birth satisfaction score (BSS) were also evaluated during the early postpartum period. RESULTS: There was a moderate negative correlation between vitamin D and VAS0 and VAS1 (r2  = 0.4, p = 0.000; r2  = -0.570, p = 0.000, respectively), and a weak negative correlation between vitamin D and VAS2 (r2  = -0.373, p = 0.000). No significant correlation was found between vitamin D and BSS and length of labor (p = 0.127, p = 0.126, respectively). CONCLUSION: In nulliparous women with low vitamin D levels, the first stage of labor and the early postpartum period may be more painful. To facilitate management of labor pain, during the antenatal period vitamin D levels should be monitored, and in cases where the levels are deficient, vitamin D supplementation should be started.


Assuntos
Dor do Parto , Trabalho de Parto , Feminino , Humanos , Dor do Parto/tratamento farmacológico , Primeira Fase do Trabalho de Parto , Parto , Gravidez , Vitamina D
4.
Midwifery ; 103: 103105, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34352600

RESUMO

OBJECTIVE: The physical and psychological benefits of exercise during pregnancy are well established. However, the impact of exercise on pain during labour and the use of epidural analgesia has been less explored. The main aim of this study was to analyse the effectiveness and safety of moderate aerobic water exercise by pregnant women on the subsequent use of epidural analgesia during labour, induction of labour, mode of delivery, and pain perception. DESIGN: A multi-centre, parallel, randomised, evaluator blinded, controlled trial in a primary care setting. SETTING: Primary care centres in a health district of a tertiary obstetric metropolitan hospital in Mallorca, Spain. PARTICIPANTS: Pregnant women (14 to 20 weeks' gestation) who had low risk of complications. METHODS: Three hundred and twenty pregnant women were randomly assigned to two groups: women who practiced moderate aquatic aerobic exercise with usual antenatal care, and those who received usual prenatal care alone. The gynaecologist, anaesthesiologist and midwife who assisted the women during labour were blinded to group allocations. Principal outcome: use of epidural analgesia during labour. Other outcomes: use of epidural analgesia before 6 cm cervical dilation, labour pain, type of delivery, time of active labour, episiotomy or perineal tear, and induction of labour. RESULTS: The exercise program did not affect the use of epidural analgesia (OR = 0.79, 95% CI = 0.44 to 1.40), vaginal delivery (OR = 1.35, 95% CI = 0.73 to 2.41), or caesarean section (OR = 0.94, 95% CI = 0.47 to 1.89). However, women in the exercise group reported less pain during labour (mean difference: -0.6, 95% CI = -1.11 to -0.09). The two groups (moderate aquatic aerobic exercise versus usual antenatal care) showed no significant differences in maternal or newborn adverse events. CONCLUSION: Aquatic aerobic exercise during pregnancy had no effect on the use of epidural analgesia during labour, whereas pain perception was lower after aquatic exercise compared to usual care in pregnancy. The intervention was safe for pregnant women and their newborns.


Assuntos
Analgesia Epidural , Analgesia Obstétrica , Dor do Parto , Trabalho de Parto , Cesárea , Exercício Físico , Feminino , Humanos , Recém-Nascido , Dor do Parto/terapia , Gravidez , Água
5.
Acta Med Port ; 34(4): 272-277, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-34214419

RESUMO

INTRODUCTION: In the current century, increasing importance has been given to the opinions, expectations and experiences of women using healthcare services. The fulfillment of expectations is determined by satisfaction. This study aims to analyze both expectations and satisfaction during childbirth regarding labor epidural analgesia among parturients, with a focus on myths. MATERIAL AND METHODS: A prospective observational study was conducted in parturients at the Centro Hospitalar Universitário Lisboa Norte - Santa Maria Hospital in Lisbon, Portugal, applying a questionnaire to 317 random women. SPSS v22.0 was used for data analysis. RESULTS: Three hundred questionnaires were returned, from women with a mean age of 31. Among the respondents, 46.3% had a college degree and 64% were employed, 46% were primiparas and only 14% had a previous anesthesiology appointment for childbirth purposes. The overall degree of satisfaction surrounding the birth experience was good/excellent for 87% of women. Labor epidural analgesia was performed on 96% of all patients, with an excellent/good outcome for 82.1% and a higher than expected results for 40.7% of them. Regarding the myths, 52.5% believed that epidural analgesia imposes a dose limit and 58.9% that it often causes permanent back pain. The level of education was significantly associated with some myths (p < 0.05), since women with a higher level of education do not believe most of them. DISCUSSION: This study supports the need for an evaluation of the current information that women have about labor epidural analgesia/childbirth. Women's individual needs can be met by multidisciplinary teams including Anesthesiology specialists. CONCLUSION: Maternal satisfaction with childbirth and analgesia is a complex and dynamic process that includes and is not limited to the relief of pain.


Assuntos
Analgesia Epidural/efeitos adversos , Dor do Parto/psicologia , Trabalho de Parto , Parto/psicologia , Satisfação do Paciente , Adulto , Analgesia Obstétrica , Estudos Transversais , Feminino , Humanos , Trabalho de Parto/psicologia , Pessoa de Meia-Idade , Motivação , Satisfação Pessoal , Portugal , Gravidez , Estudos Prospectivos , Centros de Atenção Terciária
6.
Clin Obstet Gynecol ; 64(3): 558-571, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34323234

RESUMO

Acupuncture is the procedure of inserting fine needles into specific points on the body for therapeutic purposes. Acupuncture and its derivatives (acupressure, moxibustion, electroacupuncture, and transcutaneous electric nerve stimulation on acupoints) are a popular treatment choice in the peripartum period (32 wk' gestation to 14 d postdelivery). There is substantial research evidence supporting acupuncture and its derivatives in the peripartum period. Benefits in the use of acupressure to reduce labor pain intensity and a reduction in the duration of labor with acupressure have been found. There is mixed evidence for the use of both moxibustion and moxibustion with acupuncture for noncephalic presentations and for acupressure for reducing intraoperative nausea. There is limited evidence available on acupuncture use in women with high-risk pregnancies or multifetal gestations.


Assuntos
Acupressão , Terapia por Acupuntura , Dor do Parto , Trabalho de Parto , Feminino , Humanos , Dor do Parto/terapia , Período Periparto , Gravidez
7.
Clin Obstet Gynecol ; 64(3): 635-647, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34323237

RESUMO

Hypnosis, the induction of a naturally relaxed state of mind and body, is most commonly practiced by pregnant women in preparation for the childbirth experience. A literature review was performed to assess the effects of hypnosis before, during and after pregnancy. The majority of data is extracted from case series and low-quality studies thereby limiting the acceptability of hypnosis for various pregnancy related conditions. A few well-designed studies show that self-hypnosis may be beneficial for mitigating labor pain and fear of childbirth. Women can safely pursue hypnotherapy during pregnancy; however, high quality trials are needed to demonstrate its complete efficacy.


Assuntos
Hipnose , Dor do Parto , Obstetrícia , Feminino , Humanos , Dor do Parto/terapia , Gravidez
8.
BMC Pregnancy Childbirth ; 21(1): 480, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215198

RESUMO

BACKGROUND: Performing exercise with medium intensity has positive effects on the maternal health. The aim of this study was to investigate the effectiveness of Pilates exercise program during pregnancy on childbirth outcomes: METHODS: This clinical trial study was performed on 110 primiparous women who were randomly divided into two groups of intervention (n = 55) and control (n = 55). The intervention group performed Pilates exercises from 26 to 28 weeks of gestation for 8 weeks while the control group did not do any exercise. Data collection tools included Visual Analog Scale (VAS), Mackey Childbirth Satisfaction Rating Scale, and a checklist including demographic and obstetrics information. RESULTS: The results of the study showed that Pilates exercise during pregnancy significantly reduces the labor pain intensity, length of the active phase and second stage of labor and increases maternal satisfaction of the labor process (p < 0.05). Based on the Kaplan Meyer analysis, the mean whole length of labor was shorter in Pilates exercise group than in the control group (P = .004). There was no statistically significant difference between the two groups in terms of Episiotomy, type of delivery, first and fifth Apgar score of neonates (p > 0.05). CONCLUSION: According to the results of this study, Pilates exercise during pregnancy improved the labor process and increased maternal satisfaction of chidbirthprocess, without causing complications for the mother and baby. However, studies with larger sample sizes are recommended to prove the efficacy and safty of this practiceduring labor. TRIAL REGISTRATION: IRCT registration number: IRCT20200126046266N1 . Registration date: 2020-05-02 (retrospectively registered).


Assuntos
Técnicas de Exercício e de Movimento , Terapia por Exercício/métodos , Dor do Parto/terapia , Trabalho de Parto/fisiologia , Avaliação de Programas e Projetos de Saúde , Adulto , Coleta de Dados/métodos , Feminino , Humanos , Irã (Geográfico) , Paridade , Parto/fisiologia , Parto/psicologia , Satisfação do Paciente , Gravidez , Método Simples-Cego , Análise de Sobrevida , Resultado do Tratamento
9.
Pain Res Manag ; 2021: 8835677, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34093926

RESUMO

Introduction: Delivery of the infant into the arms of a conscious and pain-free mother is the most exciting and rewarding moment in maternal care services. Physical and mental care of women during delivery requires good knowledge and a positive insight to the needs and rights of the mothers. Little was known regarding skilled birth attendants' knowledge, attitude, and practice towards labor pain management in the study area. Hence, the current study aimed at assessing knowledge, attitude, and practice, and associated factors towards labor pain management among skilled birth attendants working at hospitals found in central, west, and north Gondar zones, northwest Ethiopia, 2019. Method: A multicenter institution-based cross-sectional study was conducted from June 1 to 30, 2019. A census sampling technique was used to include a total of 336 skill birth attendants. A pretested standardized self-administered questionnaire was used to collect the data. The data were then entered into Epi Info 7.1.2 and exported to SPSS version 25 for analysis. Multivariable logistic regression analyses were undertaken to identify factors associated with outcome variables. The level of significance of the study was declared based on adjusted odds ratio with 95% confidence interval at a p value of ≤0.05. Result: The proportion of skill birth attendants having good knowledge, a favorable attitude, and a good practice on labor pain relief methods was 47%, 41.96%, and 57.14%, respectively. Age of ≤30 years (AOR = 5.43; 95% CI: 1.25, 23.53), educational status of 2nd degree and above (AOR = 3.56; 95% CI: 1.32, 9.60), working at a private primary hospital (AOR: = 6.55; 95% CI: 2.15, 19.93), and working at a referral hospital (AOR = 2.24 : 95% CI: 1.01, 4.93) are factors significantly associated with good knowledge while having good knowledge on labor pain relief methods (AOR = 2.26; 95% CI: 1.42, 3.60) and working at private primary hospitals (AOR = 7.01; 95% CI: 1.92, 25.65) had statistically significant association with favorable attitude and good practice on labor pain relief methods, respectively. Conclusion and Recommendations. Poor knowledge, unfavorable attitude, and poor practice towards labor pain management were found in this study. Strengthening the capacity of public health facilities and providing continuous professional development (CPD) training for the skilled birth attendants would be helpful in improving knowledge, attitude, and practice towards labor pain management.


Assuntos
Dor do Parto/terapia , Manejo da Dor/psicologia , Competência Profissional/estatística & dados numéricos , Estudos Transversais , Etiópia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Manejo da Dor/estatística & dados numéricos , Gravidez
10.
Acta Obstet Gynecol Scand ; 100(9): 1678-1687, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34115883

RESUMO

INTRODUCTION: Some women keep on recalling intense labor pain experienced at childbirth to a degree that may negatively affect their life during the postpartum period or lead them to request a cesarean section (CS) in the subsequent delivery. This longitudinal study aimed to assess the impact of severe recalled labor pain from the previous birth on the preference for and delivery by an elective CS in the subsequent delivery. Furthermore, we investigated whether co-occurring maternal demographic, somatic and mental health factors related to the previous and subsequent delivery, explain parts of a potential association. MATERIAL AND METHODS: The study sample comprised 1135 parous women from the Akershus Birth Cohort. Severe recalled labor pain was assessed on a numeric rating scale at pregnancy week 17, and at pregnancy week 32, the preference for an elective CS for the subsequent delivery was assessed. Information on actual delivery by elective CS in the subsequent delivery was retrieved from the electronic birth record. Logistic regression analyses were conducted to examine the impact of severe recalled labor pain on elective CS. RESULTS: Severe recalled labor pain at the previous birth was associated with a preference for an elective CS (odds ratio [OR] 3.57, 95% confidence interval [CI] 2.25-5.67) and actual delivery by elective CS (OR 4.71, 95% CI 2.32-9.59). This association remained statistically significant for the preference for an elective CS (adjusted OR [aOR] 2.12, 95% CI 1.24-3.62) but diminished for delivery by elective CS (aOR 2.30, 95% CI 0.99-5.35) when adjusting for a variety of covariates. Factors related to previous childbirth such as number of years since previous birth, assisted vaginal delivery, anal sphincter lesions, overall birth experience and fear of childbirth were also linked to preference for and delivery by an elective CS. CONCLUSIONS: Women with severe recalled labor pain were about twice as likely to prefer an elective CS compared with women without severe recalled pain. For actual delivery, the significant association with severe recalled pain diminished after adjustment for covariates. However, sample size was small and, irrespective of severe recalled labor pain, preference for an elective CS was statistically significantly associated with actual delivery by elective CS.


Assuntos
Cesárea , Procedimentos Cirúrgicos Eletivos , Dor do Parto/psicologia , Preferência do Paciente , Adulto , Estudos de Coortes , Feminino , Humanos , Noruega , Paridade , Gravidez , Inquéritos e Questionários
11.
Gynecol Obstet Invest ; 86(3): 231-238, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34192701

RESUMO

PURPOSE: The study was aimed to systematically assess the effect and safety of remifentanil patient-controlled analgesia (rPCA) versus epidural analgesia (EA) during labor. METHODS: Eligible trials were retrieved from PubMed, EMBASE, ScienceDirect, and Cochrane Library before April 2020. The primary outcomes were patient satisfaction with pain relief and average visual analog scale (VAS) pain scores during labor; the secondary outcomes were rate of spontaneous delivery, oxygen desaturation, maternal hyperthermia, and neonatal Apgar scores <7 at 1 and 5 min. RESULTS: Eleven studies involving 3,039 parturients were included. We found that parturients receiving rPCA were similarly satisfied with pain relief compared to those receiving EA (standardized mean difference: -0.19; 95% confidence interval [CI]: -0.57, 0.18), though had significantly higher VAS pain scores during labor (weighted mean difference: 1.41; 95% CI: 0.32, 2.50). The rate of spontaneous delivery was comparable. rPCA increased the risk of maternal oxygen desaturation (risk ratio [RR]:3.23, 95% CI: 1.98, 5.30). There was no statistical significance regarding hyperthermia (RR: 0.49, 95% CI: 0.24, 1.01). No significant difference was found for neonatal Apgar scores <7 at 1 and 5 min. CONCLUSION: rPCA could be an optional alternative for pain relief to EA without worsening maternal satisfaction with pain relief, delivery modes, or neonatal morbidity. However, rPCA was associated with higher pain intensity during labor and higher incidence of maternal oxygen desaturation. The routine use of rPCA in labor must be armed with close respiratory monitoring. Continued well-designed studies are required to provide more robust evidence.


Assuntos
Analgesia Epidural , Analgesia Obstétrica , Dor do Parto , Analgesia Epidural/efeitos adversos , Analgesia Obstétrica/efeitos adversos , Analgesia Controlada pelo Paciente , Feminino , Humanos , Recém-Nascido , Dor do Parto/tratamento farmacológico , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Remifentanil
12.
J Clin Nurs ; 30(23-24): 3398-3414, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34075656

RESUMO

AIMS AND OBJECTIVES: To compare and rank the efficacy and safety of non-pharmacological interventions in the management of labour pain. BACKGROUND: Recently, various non-pharmacological interventions have been applied to manage labour pain and have shown positive effects. However, evidence identifying which type of non-pharmacological intervention is more efficient and safer is limited. DESIGN: Systematic review and Bayesian network meta-analysis based on PRISMA-NMA. METHODS: Seven databases were searched from database inception-March 2020. Two reviewers independently performed study selection, quality appraisal and data extraction. Conventional meta-analysis was conducted using either fixed-effects model or random-effects model according to statistical heterogeneity. The Bayesian network meta-analysis was conducted using the consistency model. RESULTS: 43 studies involving nine non-pharmacological interventions were included. The Bayesian network meta-analysis showed that acupressure (SMD = -2.00, 95% CrI -3.09 to -0.94), aromatherapy (SMD = -2.01, 95% CrI -3.70 to -0.35) and massage therapy (SMD = -1.26, 95% CrI -2.26 to -0.30) had significant positive effects on alleviating labour pain, with aromatherapy being the most effective. The results also revealed that yoga (SMD = -130.85, 95% CrI -212.01 to -59.32) and acupressure (SMD = -10.14, 95% CrI -20.24 to -0.41) were the most effective interventions for shortening the first stage and the second stage of labour, respectively. There were no significant differences between non-pharmacological interventions and usual care or placebo control on the use of pharmacological methods and neonatal 5-min Apgar score. CONCLUSIONS: The evidence in this network meta-analysis illustrates that non-pharmacological interventions are effective and safe for labour pain management in low-risk pregnant women. In the future, well-designed studies are needed to validate the conclusion of this network meta-analysis. RELEVANCE TO CLINICAL PRACTICE: The results support the use of non-pharmacological interventions, especially aromatherapy and acupressure, to relieve labour pain in low-risk pregnant women. Non-pharmacological interventions for labour pain management are recommended to apply according to maternal women's preference and values.


Assuntos
Acupressão , Dor do Parto , Analgésicos , Teorema de Bayes , Feminino , Humanos , Dor do Parto/terapia , Metanálise em Rede , Gravidez
13.
J Clin Nurs ; 30(15-16): 2301-2308, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33960065

RESUMO

AIM AND OBJECTIVES: This study was conducted to determine the effect of showing images of the foetus to the pregnant women with the virtual reality glass during labour process on labour pain, childbirth perception and anxiety level. BACKGROUND: Virtual reality is an effective and inexpensive method that allows the creation of simulated scenarios in which it interacts with the virtual environment with multisensory stimuli. DESIGN: This is a randomised controlled experimental study. This study was conducted with the guidelines of Consolidated Standards of Reporting Trials (CONSORT). The study was enrolled in the Clinical Trials database (NCT04664114). METHODS: The study included 100 pregnant women (50 intervention group and 50 control group). Ultrasound images of the foetus were recorded on the 28th week of pregnancy of the women in the intervention group. These images were shown to the women with the virtual reality glass during labour process. Routine procedures were carried out for the women in the control group. The Visual Analog Scale (VAS) was applied to both groups when cervical dilatation was 4 cm and 9 cm. The Women's Perception for the Scale of Supportive Care Given During Labor (POBS) and the Perinatal Anxiety Screening Scale (PASS) were applied almost two hours after labour. RESULTS: The VAS scores of the women in the intervention group with 9 cm dilatation and their PASS mean scores were significantly lower than women in the control group while their POBS score were significantly higher (p < 0.01). CONCLUSION: The results of this study show that showing images of the foetus to women with virtual reality decreased labour pain and anxiety level. RELEVANCE TO CLINICAL PRACTICE: It is known that supportive care given during labour is important both for the mother's and baby's health. Therefore, it is important that nurses and midwives, who spend the most time with women and provide the most support, reduce the pain and anxiety of the woman with nonpharmacological practices and make them feel positive feelings about delivery.


Assuntos
Dor do Parto , Realidade Virtual , Ansiedade , Feminino , Feto , Humanos , Percepção , Gravidez
14.
Ugeskr Laeger ; 183(19)2021 05 10.
Artigo em Dinamarquês | MEDLINE | ID: mdl-33998455

RESUMO

Some pregnant women use capsaicin patches placed on the lower back as pain relief during labour. The effect of prescription capsaicin patches for treatment of neuropathic pain is pharmacologically documented. There are no studies on the effect of capsaicin patches on labour pain. In this case report, capsaicin patches placed on the lower back prevented epidural analgesia during labour and spinal anaesthesia for suturing of perineal rupture due to oedema and erythema of the skin. Due to lack of evidence, neuraxial anaesthesia after the use of capsaicin patches on the lower back are contraindicated.


Assuntos
Analgesia Epidural , Analgesia Obstétrica , Dor do Parto , Trabalho de Parto , Capsaicina , Feminino , Humanos , Gravidez
15.
Acta Biomed ; 92(2): e2021065, 2021 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-33988155

RESUMO

BACKGROUND: Opioid analgesics had been used from time to time for treating labor pain. However, their use have been concerning. The aim of this study is to evaluate the effect of pethidine on duration of active phase of labor, labor pain and maternal-neonatal outcomes. METHODS: In the present case-control study, the study group received a 50 mg pethidine intramuscular injection upon the start of active phase of labor, and the control group consisted of patients who receive placebo injeciton. In both groups, vital signs were measured before, and at 0, 5, 15, 30, 45 and 60 minutes after the injection. Pain intensity was evaluated with Visual Analogue Scale (VAS) prior to, and 1 hour and 2 hours after injection. Data regarding labor phase durations, maternal side effects, newborn APGAR scores and fetal respiratory problems were recorded. RESULTS: 102 patients in Pethidine group and 92 patients in control group, were included into the study. Labor pain VAS-scores were significantly lower in the study group (p<0.001). Moreover, active phase of labor duration was significantly shorter in the study group (p<0.001). Maternal pulse significantly decreased, and maternal nausea-vomiting was frequent in the study groups. However, the groups were similar in terms of other side effects and neonatal outcomes. CONCLUSIONS: Pethidine significantly reduces active phase of labor duration, has a favorable analgesic effect in treating labor pain and is not associated with serious maternal or neonatal complications. It is therefore considered an acceptable agent for use during active phase of labor.


Assuntos
Analgesia Obstétrica , Dor do Parto , Analgésicos Opioides , Feminino , Humanos , Recém-Nascido , Dor do Parto/tratamento farmacológico , Meperidina , Manejo da Dor , Gravidez
16.
Expert Rev Clin Pharmacol ; 14(8): 1051-1056, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33980116

RESUMO

OBJECTIVES: This study aims to estimate the EC50 of ropivacaine when co-administered with dexmedetomidine for epidural labor analgesia in antepartum obese and non-obese parturients. METHODS: Sixty parturients scheduled for epidural labor analgesia were enrolled and divided into antepartum obesity (AO) and control (CON) groups, according to their body mass index at labor. Both groups received 0.5 µg/mL dexmedetomidine with ropivacaine as anesthetics. The concentration of ropivacaine was initially set at 0.125% and varied by 0.01% according to the up-and-down rule for sequential allocation. Hemodynamic parameters were monitored and pain intensity was assessed using a visual analog scale. RESULTS: When co-administered with dexmedetomidine, the EC50 of ropivacaine was 0.095% (95% confidence interval [CI]: 0.090-0.100%) and 0.070% (95% CI: 0.062-0.076%) in CON and AO groups, respectively. There was a significant difference between the two groups (P < 0.001). EC95 values of ropivacaine were 0.084% (95% CI: 0.077-0.122%) and 0.106% (95% CI: 0.101-0.128%) in AO and CON groups, respectively. CONCLUSION: Patients with antepartum obese may require decreased ropivacaine concentration for epidural labor analgesia when co-administered with 0.5 µg/mL dexmedetomidine.


Assuntos
Dexmedetomidina/administração & dosagem , Dor do Parto/tratamento farmacológico , Obesidade/complicações , Ropivacaina/administração & dosagem , Adulto , Analgesia Epidural/métodos , Analgesia Obstétrica/métodos , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/farmacologia , Anestésicos Locais/administração & dosagem , Anestésicos Locais/farmacologia , Dexmedetomidina/farmacologia , Feminino , Humanos , Trabalho de Parto , Medição da Dor , Gravidez , Ropivacaina/farmacologia
18.
J Obstet Gynecol Neonatal Nurs ; 50(4): 369-381, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34033757

RESUMO

Pain relief during childbirth continues to stimulate controversy as new treatments emerge and continuing interventions in the birth process invoke concerns about safety, technologic imperatives, and informed consent. In this historical commentary, I identify a complex dissonance between scientific advances and women's needs and expectations regarding childbirth. Evidence-based practice became the standard during the last 50 years and has reinforced a more conservative and parsimonious use of technology to respond to women's needs for pain relief. In reviewing this history, it is apparent that pain relief during labor is inextricably linked to interventions. Nurses can advance evidence-based practice and facilitate robust informed consent as they support women during childbirth.


Assuntos
Analgesia Obstétrica , Dor do Parto , Trabalho de Parto , Feminino , Humanos , Dor do Parto/terapia , Manejo da Dor , Parto , Gravidez
19.
Zhen Ci Yan Jiu ; 46(3): 231-4, 2021 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-33798297

RESUMO

OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS)combined with epidural analgesia on postpartum depression and to explore its underlying mechanism. METHODS: One hundred and twenty cases of full-term primiparous women with singleton pregnancy were selected from May 2018 to November 2018 in Jinzhong Maternal and Child Health Hospital. The parturients with labor analgesia requirement were randomly divided into the epidural group and the combination group, and the parturients without labor analgesia requirement were used as the control group, with 40 cases in each group. Patients in the control group did not receive labor analgesia and were treated according to the routine procedures of natural delivery; patients in the epidural group received epidural labor analgesia; patients in the combination group received TEAS at bilateral Hegu(LI4), Sanyinjiao(SP6) and Zusanli(ST36) (2 Hz/100 Hz, the current intensity is gradually increased from 15 mA, and the treatment was performed every 2 h, 20 min each time) combined with epidural labor analgesia. The visual analogue scale (VAS) scores were recorded when the uterine orifice opened to 3, 6, 8, 10 cm. Plasma glutamate was measured using high-performance liquid chromatography before analgesia, at the end of the third stage of labor and 42 days after delivery, and Edinburgh postnatal depression scale (EPDS) score was measured at 42 days after delivery. RESULTS: In comparison with the control group, the VAS score, EPDS score and the incidence of postpartum depression of the epidural group and the combination group were significantly lower(P<0.05), and the combination group had significant decrease than those in epidural group (P<0.05). Immediately before analgesia, there was no statistically significant difference in glutamate levels among the 3 groups (P>0.05). Compared with the control group, at the end of the third stage of labor and 42 days postpartum, the glutamate levels of the epidural group and the combination group were significantly reduced(P<0.05), and the combination group decreased more significantly than the epidural group (P<0.05). CONCLUSION: TEAS combined with epidural analgesia can reduce the incidence of postpartum depression, possibly by down-regulating plasma glutamate level and relieving of labor pain.


Assuntos
Analgesia Epidural , Depressão Pós-Parto , Dor do Parto , Trabalho de Parto , Estimulação Elétrica Nervosa Transcutânea , Pontos de Acupuntura , Criança , Depressão Pós-Parto/terapia , Feminino , Humanos , Dor do Parto/tratamento farmacológico , Gravidez
20.
Reprod Health ; 18(1): 86, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892749

RESUMO

BACKGROUND: Women have experienced labour pain over the years as various attempts have been made to effectively manage this pain. There is paucity of literature on the experiences and perceptions about labour pain management with the contemporary Ghanaian health system. This study explored the perspective of puerperal women on the use of non-pharmacological labour pain management at Adidome Government Hospital. METHODS: The study adopted an exploratory descriptive qualitative approach as data was collected through individual interviews. Informed consent was obtained from all participants who were purposely sampled until data saturation was reached on the 17th participant. Interviews were audio recorded and transcribed immediately. Thematic analysis was engaged in three interrelated stages, namely data reduction, data display, and data conclusion to analyse the transcript and field notes. Results were presented with supporting quotes from the transcripts. RESULTS: The women described labour pain as very severe, severe and moderate as the pain lasted more than 12 h. The various strategies adopted in managing labour pains included shouting and walking around, crying and screaming and staying calm and snapping the fingers. Other pain management strategies adopted during labour included women engaged in deep breathing exercises, chatting with other people and relatives, diversion therapy, reassurance, taking a shower, assuming side lying positions, and receiving intravenous therapy. The presence of the husband of a labouring woman during labour improved pain bearing ability. CONCLUSION: It is important that midwives institute pragmatic protocols in the labour ward that ensure a relaxing atmosphere for women in labour, respond to the sensitivity and specificity of labouring women needs and when possible significant others (e.g., husband) of the labouring women could be allowed to visit. Labour wards should be made sound proof to allow women the ability to express themselves satisfactorily during labour without fear of being heard outside.


Assuntos
Dor do Parto/terapia , Trabalho de Parto , Manejo da Dor/métodos , Adulto , Feminino , Gana , Humanos , Entrevistas como Assunto , Satisfação do Paciente , Gravidez , Pesquisa Qualitativa
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