Fetomaternal Outcome and Epidural Anesthesia
- 1. Associate Professor, Department of OBGY, Dr. Ulhas Patil Medical College and Hospital Jalgaon
- 2. Assistant Professor, Department of OBGY, Dr. Ulhas Patil Medical College and Hospital Jalgaon
Description
Introduction: A treatment to make a woman more comfortable during childbirth is called an epidural anaesthesia. The area of the spine where local anaesthetic is administered is referred to as the “epidural.” It is a local anaesthetic that causes a person’s feet to freeze up to their abdomen. The patient can participate actively in all aspects of the childbirth process while fully awake. Both nonpharmacological and pharmacological analgesic techniques can alter the pain pathways. Assist in the early and second stages of labour with improved pain management. Promote the participation of the expectant mother during labour and delivery. This study looked at how epidural analgesia affected maternal and foetal outcomes in women who were having their induction of labour. Material and Methods: A complete physical examination of 110 low risk primigravida patients who were at term and in labour (>=4 cm) was performed. Physical status ASA 1 individuals received epidural analgesia and acted as cases. Primigravida who met the inclusion criteria and reported in the delivery room or antenatal clinic were given the choice of receiving epidural analgesia. In addition to conducting a clinical examination, a thorough relevant history was acquired. Informed written agreement was obtained from the expectant mother and her family members who agreed to receive epidural analgesia. An anaesthetist placed the epidural catheter in the operating theatre. The CTG (cardiotocography) was used to record baseline variables such heart rate, blood pressure, SpO2, and FHR. Results: The mean Apgar score of neonates at one minute was 9.57±1.54 while mean Apgar score at 5 minutes was 10.2±1.64.In terms of pain relief, the majority of patients 71,( 64.55%) reported no pain, 23 (20.91%) reported mild pain, 11 (10%) reported moderate pain, and 5 (4.55%) reported severe pain. The majority of the patients (n 68, 61.82%), with a mean age of 24.9 ± 2.1 years, were in the 20–25 age range. 59 patients (53.64%) gave birth naturally by vaginal delivery; 6 patients (5.45%) used forceps; 9 patients (8.18%) used ventouse, and 36 patients (32.73%) required a cesarean section (LSCS). Conclusion: Thus, epidural analgesia aims to make labour a pleasant, and pain-free event and offers good pain relief for the majority of the patients. It was not linked to foetal compromise, but it was linked to an enhanced second stage of labour. Consequently, epidural analgesia is among the best and safest methods of pain management.
Abstract (English)
Introduction: A treatment to make a woman more comfortable during childbirth is called an epidural anaesthesia. The area of the spine where local anaesthetic is administered is referred to as the “epidural.” It is a local anaesthetic that causes a person’s feet to freeze up to their abdomen. The patient can participate actively in all aspects of the childbirth process while fully awake. Both nonpharmacological and pharmacological analgesic techniques can alter the pain pathways. Assist in the early and second stages of labour with improved pain management. Promote the participation of the expectant mother during labour and delivery. This study looked at how epidural analgesia affected maternal and foetal outcomes in women who were having their induction of labour. Material and Methods: A complete physical examination of 110 low risk primigravida patients who were at term and in labour (>=4 cm) was performed. Physical status ASA 1 individuals received epidural analgesia and acted as cases. Primigravida who met the inclusion criteria and reported in the delivery room or antenatal clinic were given the choice of receiving epidural analgesia. In addition to conducting a clinical examination, a thorough relevant history was acquired. Informed written agreement was obtained from the expectant mother and her family members who agreed to receive epidural analgesia. An anaesthetist placed the epidural catheter in the operating theatre. The CTG (cardiotocography) was used to record baseline variables such heart rate, blood pressure, SpO2, and FHR. Results: The mean Apgar score of neonates at one minute was 9.57±1.54 while mean Apgar score at 5 minutes was 10.2±1.64.In terms of pain relief, the majority of patients 71,( 64.55%) reported no pain, 23 (20.91%) reported mild pain, 11 (10%) reported moderate pain, and 5 (4.55%) reported severe pain. The majority of the patients (n 68, 61.82%), with a mean age of 24.9 ± 2.1 years, were in the 20–25 age range. 59 patients (53.64%) gave birth naturally by vaginal delivery; 6 patients (5.45%) used forceps; 9 patients (8.18%) used ventouse, and 36 patients (32.73%) required a cesarean section (LSCS). Conclusion: Thus, epidural analgesia aims to make labour a pleasant, and pain-free event and offers good pain relief for the majority of the patients. It was not linked to foetal compromise, but it was linked to an enhanced second stage of labour. Consequently, epidural analgesia is among the best and safest methods of pain management.
Files
IJTPR,Vol12,Issue7,Article14.pdf
Files
(161.7 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:45ab9fafacd111ade1c8aca30b4badc8
|
161.7 kB | Preview Download |
Additional details
Dates
- Accepted
-
2022-06-30
Software
References
- 1. Madhu KN, Dileep Kumar H. R. Fetomaternal outcome in subject undergoing epidural labour analgesia with Ripovacaine and Fentanyl. Int J Reprod Contracept Obstet Gynecol. 2018 Feb;7(2):659-664 2. Abhirami, G.R., Sathyavani, C. & George, C.E. The Effect of Epidural Analgesia on the Maternal and Fetal Outcomes in Mothers Undergoing Induction of Labour. J Obstet Gynecol India (2022). 3. Camann WR. Conference report: Highlights of the 35th Annual Meeting of the Society for Obstetric Anesthesia and Perinatology, May 14–17, 2003; Phoenix, Arizona, US. Available at: http://www.medscape.com/- viewarticle/456179. 4. Satpathy HK, Chief editor: Alex Macario. Labor and delivery, analgesia, regional and local: overview, indications, contraindication. Available at http://emedicine.medscape.com/article/1 49337overview#a8. 5. Rimaitis K, Klimenko O, Rimaitis M, Morkūnaitė A, Macas A. Labor epidural analgesia and the incidence of instrumental assisted delivery. Medicina. 2015;51(2):76-80 6. Flint AP, Forsling ML, Mitchell MD. Blockade of the Ferguson reflex by lumbar epidural anaesthesia in the parturient sheep: effects on oxytocin secretion and uterine venous prostaglandin F levels. Horm Metab Res. 1978;10(6):545-547. 7. Papalkar J, Shrivastava D, Labour EA. International journal of biological and medical research. Int J Biol Med Res. 2013;4(1):2707–2712. 8. Halpern SH, Walsh V. Epidural ropivacaine versus bupivacaine for labor: a meta-analysis. Anesth Analg. 2003; 96(5):1473–1479. 9. Deshmukh VL, Ghosh SS, Yelikar KA, Gadappa SN. Effects of Epidural Labour Analgesia in Mother and Foetus. J Obstet Gynaecol India. 2018;68(2): 111-116. 10. Beilin Y, Mungall D, Hossain S, Bodian CA. Labor pain at the time of epidural analgesia and mode of delivery in nulliparous women presenting for an induction of labour. Obstet Gynecol 2009; 114:764-9. 11. Saunders JN, Spiby H, Gulbert L, Fraser RB, Hall JM, Mutton PM, Jackson A, Edmond DK. Oxytocin infusion during second stage of labour in primiparous women using epidural analgesia: a randomized double blind placebo controlled trial. Br Med J 1989; 299:1423-6 12. Anwar S, Anwar MW, Ayaz A, Danish N, Ahmad S. Effect of epidural analgesia on labor and its outcomes. J Ayub Med Coll Abbottabad. 2015;27(1):146–150. 13. Desai P, Patel P, Gupta A, et al. Epidural analgesia in labor. J Obstet Gynaecol India. 2006;56(5):417–422.