Obstetric analgesia in labor and its association with neonatal outcomes

Silva, Yasmin Aparecida Pires; Araújo, Fernanda Gontijo; Amorim, Torcata; Martins, Eunice Francisca; Felisbino-Mendes, Mariana Santos

doi:10.1590/0034-7167-2018-0757

Cited by 10 publications

(11 citation statements)

References 22 publications

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“…The severe pain of vaginal delivery [ 1 ] may cause negative emotions such as fear and worry, and may also result in syncope, weakness, and even fetal distress, cesarean section, and fetal death in severe cases [ 2 ]. Labor pain will elicit physiological stresses and perinatal complications [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Intraspinal nerve block anesthesia for labor analgesia features satisfactory nerve block and ideal analgesic effect, but the uncertainty of its effect on the labor process and the fetus has prevented its widespread implementation in China [ 5 ]. Epidural analgesia is associated with a significantly elevated incidence of intrapartum fever [ 2 ]. Intradural labor analgesia causes antepartum noninfectious fever, probably because epidural anesthesia dilates the limb vessels below the plane of anesthesia to increase convective radiation heat dissipation, and reduces skeletal muscle activity to decrease thermogenesis.…”

Section: Introductionmentioning

confidence: 99%

“…Intradural labor analgesia causes antepartum noninfectious fever, probably because epidural anesthesia dilates the limb vessels below the plane of anesthesia to increase convective radiation heat dissipation, and reduces skeletal muscle activity to decrease thermogenesis. In addition, the asynchrony of anesthesia on cold and heat sensory blocks leads to early onset of thermothermal block and deviation of body temperature information from the thermoregulatory center, resulting in elevated body temperature during labor [ 2 ]. However, fever due to intralesional analgesia does not usually exceed 38°C, and fever above 38°C is associated with chorioamnionitis.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Intraspinal Nerve Block Anesthesia on Intrapartum Fever and the Neonate

Wang

Chang

Chen

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the impact of intraspinal nerve block anesthesia on intrapartum fever and the neonate. Methods. In this prospective study, between October 2019 and December 2020, 90 eligible primiparous women enrolled in the obstetrics and gynecology department of our hospital for delivery were recruited and assigned via the random number table method at a ratio of 1 : 1 to either an analgesic group given intraspinal nerve block anesthesia for labor or a nonanalgesic group without anesthesia for labor. Outcome measures included intrapartum body temperature, cases of intrapartum fever, Apgar scores of neonates, visual analogue scale (VAS) scores, delivery mode, and indomethacin use. Results. Intraspinal nerve block anesthesia was associated with a higher body temperature at 4 h and 5 h after analgesia and more cases of intrapartum fever versus no anesthesia ( P < 0.05 ). There were no significant differences in the Apgar scores between the two groups ( P > 0.05 ). Participants given intraspinal nerve block anesthesia had lower VAS scores during labor versus those without anesthesia ( P < 0.05 ). The differences in the delivery mode between the two groups were not significant ( P > 0.05 ). Intraspinal nerve block anesthesia resulted in a significantly higher demand for indomethacin versus no anesthesia ( P < 0.05 ). Conclusion. Intraspinal nerve block anesthesia is clinically effective in labor analgesia but may cause increased body temperature or even overt clinical fever, so close clinical observation of maternal temperature changes is required to mitigate the effects of anesthesia on the mothers. No adverse consequences of intraspinal nerve block anesthesia on the newborns were reported in this study.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Intraspinal Nerve Block Anesthesia on Intrapartum Fever and the Neonate

Wang

Chang

Chen

2022

Evidence-Based Complementary and Alternative Medicine

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“…As pesquisas que abordam a influência de intervenções obstétricas sobre o bem-estar fetal são iniciativas ainda recentes e não costumam estar associadas a tais intervenções e desfechos neonatais, Estas realizam apenas a análise dos modelos de atenção ao parto, de forma geral e suas repercussões nos resultados perinatais ou investigam o uso de intervenções de forma individualizada e sua associação aos desfechos neonatais ocorridos, tal como o explanado na pesquisa que traz a associação da analgesia no trabalho de parto à ocorrência de manobras de reanimação e encaminhamento para unidade de terapia intensiva neonatal (8)(9) . Portanto, busca-se aprofundar a compreensão sobre a implementação das práticas assistenciais no cenário do parto e nascimento, trazendo a associação dos resultados neonatais evidenciados em cada intervenção obstétrica utilizada.…”

Section: Introductionunclassified

Neonatal outcomes associated with obstetric interventions performed during labor in nulliparous women

Monteiro¹,

Coelho²,

Lima³

et al. 2021

Rev Rene

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Objective: to analyze neonatal outcomes associated with obstetric interventions performed during labor in low-risk nulliparous women. Methods: a cross-sectional observational study of 534 low-risk nulliparous women. Results: interruption of skin-to-skin contact after delivery was shown to be associated with obstetric interventions such as cardiotocography at admission, oxytocin in labor, amniotomy, and episiotomy. The need for positive pressure ventilation and oxygen therapy was associated with the encouragement of the Valsalva maneuver; the performance of this maneuver was also associated with interventions such as amniotomy, episiotomy and directed pulling. Conclusion: the study showed that the use of obstetric interventions during labor in low-risk women is associated with unfavorable neonatal outcomes that lead to the need for further interventions after delivery.

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“…Other studies reported that epidural analgesia might increase the negative outcome of neonates [9 ~ 11]. In terms of the analgesic effect on mothers and newborns, most of the studies compared different modalities of analgesia, only a few studies compared epidural analgesia speci cally vs. non-epidural labor [12,13]. To investigate if the epidural analgesia has any effects on maternal and neonatal outcomes, the baseline characteristics and overall outcomes of both mothers and newborns, including umbilical cord blood gas analysis, were performed in the present study.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Epidural Analgesia during Labor on Maternal and Neonatal Outcomes

Huang

Yu²,

Zhang³

et al. 2020

Preprint

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Background: The purpose of the study was to investigate the impact of epidural analgesia usage vs. non-epidural labor on maternal and neonatal outcomes. Methods: We included 129 parturients who had vaginal deliveries in our hospital since December 1, 2018. The women were grouped into the epidural analgesia group or the non-epidural group. In order to investigate the effect of epidural analgesia on mother and newborn outcomes, we evaluated the differences in labor duration, the Apgar score of the newborn, and the overall outcome of the mother and newborn. Results: Compared to the non-epidural group, the durations of the first and second stages of labor in the analgesia group were significantly longer. In terms of neonatal outcome, the epidural analgesia group had a higher lactate value in the umbilical artery blood and higher pCO2 of umbilical vein blood of the neonates. However, there were no significant differences in Apgar Score, umbilical blood pH, base excess, or other umbilical cord blood gas analyses (pO2, HGB, SO2, HCO3 -) between epidural analgesia and non-epidural labor groups.Conclusion: The epidural analgesia prolongs the duration of the first and second stages of labor and affects the level of lactate in umbilical artery blood and the partial pressure of carbon dioxide in umbilical vein blood. There was no significant effect on the basic characteristics of the mothers and neonates, suggesting that epidural analgesia delivery technology is safe, but it may have a particular short-term impact on neonatal outcomes.

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Obstetric analgesia in labor and its association with neonatal outcomes

Cited by 10 publications

References 22 publications

Impact of Intraspinal Nerve Block Anesthesia on Intrapartum Fever and the Neonate

Impact of Intraspinal Nerve Block Anesthesia on Intrapartum Fever and the Neonate

Neonatal outcomes associated with obstetric interventions performed during labor in nulliparous women

The Effects of Epidural Analgesia during Labor on Maternal and Neonatal Outcomes

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