Epidural anesthesia during childbirth — retrospective analysis of maternal and neonatal results

Bączek, Grażyna; Rychlewicz, Sylwia; Sys, Dorota; Teliga-Czajkowska, Justyna

doi:10.5603/gp.a2022.0109

Cited by 2 publications

(2 citation statements)

References 39 publications

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“…It is still controversial whether intrathecal analgesia on labor increases the rate of instrumental and cesarean delivery. Previous studies have shown that epidural labor analgesia increased the risk of instrument delivery, but contrary to conventional wisdom, the incidence of cesarean section reduced [31–33]. A meta-analysis showed that epidural anesthesia prolongs the duration of the first and second stages of labor [34].…”

Section: Discussionmentioning

confidence: 99%

Cytochrome P4503A4 gene polymorphisms guide safe sufentanil analgesic doses in pregnant Chinese mothers: a multicenter, randomized, prospective study

Shu,

Yan,

et al. 2023

Pharmacogenetics and Genomics

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Background Sufentanil and ropivacaine when used as epidural anesthetics effectively reduce maternal pain during labor. From previous reports, rs2242480 single nucleotide polymorphisms (SNPs) can alter sufentanil metabolism, which affects analgesic efficacy. Methods We randomly divided 573 eligible mothers into groups A and B (in a 1 : 3 ratio). The control group (group A) was given sufentanil at the usual 0.5 mg/L-1 dose + 0.15% ropivacaine hydrochloride mixture in 10 ml. The sufentanil dose given to the intervention group (group B) was determined by genotype: the GA and AA genotype group (group B1) was given 87.6% (design based on previous study results) of the usual sufentanil clinical dose (0.438 mg/L-1 sufentanil + 0.15% ropivacaine hydrochloride mixture in 10 ml) and the GG genotype group (group B2) was given the same dose as group A. Efficacy indicators consisting of maternal vital signs, obstetric transfer, neonatal prognostic indicators, and adverse effects were recorded before and after analgesia across groups. Results Visual analog scale scores after analgesia across groups were significantly different from scores before analgesia, showing that analgesic effects across groups were effective. No significant differences were observed in efficacy, obstetric transfer, and neonatal prognosis indicators between groups. In comparison to groups B1 and B2, group A showed more markedly suppressed cardiovascular and respiratory effects, and also a higher incidence of negative side effects such as vomiting and urinary retention. Conclusion We confirmed that individualizing sufentanil doses based on maternal genotypes increased safety and success rates for women during childbirth.

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Section: Discussionmentioning

confidence: 99%

Cytochrome P4503A4 gene polymorphisms guide safe sufentanil analgesic doses in pregnant Chinese mothers: a multicenter, randomized, prospective study

Shu,

Yan,

et al. 2023

Pharmacogenetics and Genomics

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“…Epidurals are very powerful at relieving labor pain, but they are also associated with longer first and second stages of labor, and a higher risk of oxytocin augmentation, episiotomies, and operative deliveries [ 48 , 53 , 55 , 56 ]. Although the mechanisms are not fully understood, longer labor may result from a decrease in uterine activity and slower dilation of the cervix [ 57 ], possibly due to a drop in endogenous oxytocin [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Emotional factors, medical interventions and mode of birth among low-risk primiparous women in Poland

Nenko

Kopeć-Godlewska

Towner

et al. 2023

Evolution, Medicine, and Public Health

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Background and Objectives Birth is a critical event in women’s lives. Since humans have evolved to give birth in the context of social support, not having it in modern settings might lead to more complications during birth. Our aim was to model how emotional factors and medical interventions relate to birth outcome in hospital settings in Poland, where c-section rates have doubled in the last decade. Methodology We analyzed data from 2363 low-risk primiparous women who went into labor with the intention of giving birth vaginally. We used a model comparison approach to examine the relationship between emotional and medical variables and birth outcome (vaginal or c-section), including sociodemographic control variables in all models. Results A model with emotional factors better explained the data than a control model (ΔAIC = 470.8); women with continuous personal support during labor had lower odds of a c-section compared to those attended by hospital staff only (OR = 0.12, 95% CI = 0.09 - 0.16). A model that included medical interventions also better explained the data than a control model (ΔAIC = 133.6); women given epidurals in particular had an increased odds of a c-section over those who were not (OR = 3.55, 95% CI = 2.95 - 4.27). The best model included variables for both the level of personal support and the use of epidural (ΔAIC = 598.0). Conclusions and implications Continuous personal support during childbirth may be an evolutionarily informed strategy for reducing complications, including one of the most common obstetrical complications in modern hospital settings, the c-section.

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Epidural anesthesia during childbirth — retrospective analysis of maternal and neonatal results

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Ginekologia Polska" are listed in PubMed.

Cited by 2 publications

References 39 publications

Cytochrome P4503A4 gene polymorphisms guide safe sufentanil analgesic doses in pregnant Chinese mothers: a multicenter, randomized, prospective study

Cytochrome P4503A4 gene polymorphisms guide safe sufentanil analgesic doses in pregnant Chinese mothers: a multicenter, randomized, prospective study

Emotional factors, medical interventions and mode of birth among low-risk primiparous women in Poland

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