Anxiety and epinephrine in multiparous women in labor: Relationship to duration of labor and fetal heart rate pattern

Lederman, Regina P.; Lederman, Edward; Bruce, Work; McCann, Daisy S.

doi:10.1016/0002-9378(85)90692-1

Cited by 141 publications

(70 citation statements)

References 14 publications

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“…Studies considering various obstetric outcomes separately have also demonstrated associations between anxiety during pregnancy and, for example, length of labour 10,11 ; preeclampsia, prolonged labour and forceps delivery 12 ; use of anaesthesia during delivery 13 ; and preterm delivery 14 . Supporting evidence is also provided by research into the relationship between anxiety and levels of adrenaline and noradrenaline, which are known to be associated with abnormal uterine contractions and subsequent obstetric complications 10,11,15,16 .…”

Section: Introductionmentioning

confidence: 99%

Does fear of childbirth during pregnancy predict emergency caesarean section?

Johnson¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective Caesarean section rates are rising dramatically in the UK. It has been estimated that they have increased from 10% to 22% of all births over 15 years. A Swedish study has suggested that fear of childbirth during pregnancy may increase the risk of emergency caesarean section. The aim of this study is to identify whether fear of childbirth can predict the occurrence of emergency caesarean section in a UK sample. Design A prospective design using between-group comparisons.Setting Sheffield, S. Yorkshire, UK.Sample Four hundred and forty-three pregnant women, recruited at 32 weeks of gestation, over 16 years of age.Methods Participants completed self-assessment, postal questionnaires assessing fear of labour and anxiety using the Wijma Delivery Expectancy Scale (W-DEQ) and the Speilberger State Trait Anxiety Scale (STAI), together with their expectations about their mode of delivery. Delivery information was gathered via birth summary sheets. Main outcome measure Mode of delivery.Results Emergency caesarean section was associated with previous caesarean section, parity, age and a score reflecting medical risk, but not fear of childbirth or anxiety measures. There were no differences in fear between women experiencing spontaneous-vertex, forceps/ventouse, emergency or elective caesarean deliveries. The W-DEQ was factor analysed and was found to measure four distinct domains: fear, lack of positive anticipation and the degree to which women anticipate isolation and riskiness in childbirth. However, these individual factors also failed to contribute to the prediction of mode of delivery. Primiparous women in the UK sample showed highly elevated fear scores when compared with a Swedish sample. Such discrepancies were not found for the multiparous sample. Conclusions Fear of childbirth during the third trimester is not associated with mode of delivery in a UK sample. Possible cross-cultural differences are discussed.

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Section: Introductionmentioning

confidence: 99%

Does fear of childbirth during pregnancy predict emergency caesarean section?

Johnson¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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“…These techniques have gained preference while multiple randomized controlled trials have demonstrated lower maternal pain scores and higher maternal satisfaction with neuraxial analgesia comparing with systemic analgesia [12][13][14][15]. Moreover, the physiological benefits of neuraxial analgesia in what concerns maternal cardiovascular and pulmonary physiology, and the acid -base status of the fetus, are welldocumented [16][17][18][19].…”

Section: Neuraxial Analgesia and Mode Of Deliverymentioning

confidence: 99%

Predictive Factors for Cesarean Delivery ? A Retrospective Study

Alexandra¹

2015

J Preg Child Health

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“…Effective epidural analgesia reduces maternal plasma concentration of the catecholamine. Decreased alpha and beta receptor stimulation may result in improved uteroplacental perfusion and more effective uterine activity 4 . Epidural anesthesia along with a skilled anesthetist, a faithful obstetrician and a trained midwife can convert the painful labor into a less stressful event 5 .Delivery of the infant into the arms of conscious and pain free mother is one of the most rewarding feelings in medicine 6 .…”

Section: Introductionmentioning

confidence: 99%

Epidural tramadol improves the quality of pain relief during labor

et al. 2017

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To study the analgesic efficacy and side effects of Tramadol for painless labor in combination with Bupivacaine. Randomized, controlled, double blind, open prospective study conducted at Department of Obstetrics and Gynaecology, Chitwan Medical College from July 1st 2015 to June 30th 2016. 100 patients of ASA Grade I and II, aged between 20-35 years willing for epidural analgesia for labor pain were included in the study. They were divided into two groups: Group A-Control group and Group B-Study group. Subjects of Group A received 10 ml of 0.25% Bupivacaine and that of Group B received 10ml of 0.25% Bupivacaine with 1mg/kg body weight of tramadol. Analgesic efficacy was assessed by Visual Analogue Scale (VAS) and other vital parameters (Blood Pressure, Heart Rate and Respiratory Rate) before the administration of the drug and at different time intervals of 0, 5 min, 10 min, 15 min, 30 min, 45 min, 60 min and every hourly up to maximum of 5 hrs. Neonatal out comes were assessed by the use of APGAR scores and the side effects of the drugs in two groups were also evaluated. Total number of patients was 100, of ASA Grade I and II, aged between 20-35 years. The mean age of patients in Group A was 23.54 ± 3.74 years and 24.22 ± 3.64 years in Group B. Mode of delivery was spontaneous vaginal in 42 patients (84%) in group A and 45 patients (90%) in group B. Instrumental vaginal delivery was done in 1 patient (2%) of group A and none of group B. Cesarean section was done in 7 patients (14%) of group A and 5 patients (10%) of group B. There was no significant difference in heart rate, blood pressure and respiratory rate at various time intervals. Pain score of Group B was significantly less at 60th min and had lower values than Group A at various time intervals. Time for first top up was significantly delayed and the total dose of bupivacaine was significantly lower in Group B patients but the incidence of nausea and vomiting was significantly high among Group B patients. At one minute majority of the babies of group A had mean APGAR score 6.98 ± 0.55 versus 7.18 ± 0.60 in group B. At 5 minute, Group A had mean score of 8.02 ± 0.47 versus 8.22 ± 0.58 in Group B. There were no significant differences in 2 groups. In both the groups there was no significant effect on duration of second stage of labor and it wasn't prolonged in any of the patients. Epidural anesthesia with bupivacaine and tramadol provided better pain relief and reduced the total dose of bupivacaine in majority of the patients with no adverse effects on mother and fetus. As tramadol is cheap, safe and effective, it can be considered as a better option to improve quality of pain relief during labor.

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Anxiety and epinephrine in multiparous women in labor: Relationship to duration of labor and fetal heart rate pattern

Cited by 141 publications

References 14 publications

Does fear of childbirth during pregnancy predict emergency caesarean section?

Does fear of childbirth during pregnancy predict emergency caesarean section?

Predictive Factors for Cesarean Delivery ? A Retrospective Study

Epidural tramadol improves the quality of pain relief during labor

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