A comparison of the effect of epidural, general, and no anesthesia on funic acid-base values by stage of labor and type of delivery

Shyken, Jane M.; Smeltzer, James S.; Baxi, Laxmi; Ambrose, Steven; Petrie, Roy H.

doi:10.1016/0002-9378(90)91072-k

Cited by 23 publications

(16 citation statements)

References 18 publications

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“…21 Segmental epidural analgesia during labor decreases metabolic acidosis in the fetus and Apgar scores in the newborn are higher. 22,23 Apgar scores of all newborns were >7 in our study. Umbilical arterial blood gas status did not indicate any acidosis, according to the data gathered by Yeomans et al 24 The NACS, first described in 1982, was developed to distinguish between possible drug effects and in utero asphyxia, 25 though doubt has been cast on its validity.…”

Section: Discussionmentioning

confidence: 63%

Comparison of maternal and neonatal outcomes with epidural bupivacaine plus fentanyl and ropivacaine plus fentanyl for labor analgesia

Bölükbaşı

Şener

Sarıhasan

et al. 2005

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 63%

Comparison of maternal and neonatal outcomes with epidural bupivacaine plus fentanyl and ropivacaine plus fentanyl for labor analgesia

Bölükbaşı

Şener

Sarıhasan

et al. 2005

International Journal of Obstetric Anesthesia

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“…Table 1 describes the studies that have been included in the meta‐analysis 6–9,14–22 . These include some studies in which old‐fashioned epidural analgesia using local anaesthetic without opioid was used, and others using the more up‐to‐date low dose combinations.…”

Section: Methodsmentioning

confidence: 99%

Analgesia in labour and fetal acid–base balance: a meta‐analysis comparing epidural with systemic opioid analgesia

Reynolds

Sharma

Seed

2002

BJOG

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Objective To assess the effect of epidural versus systemic labour analgesia on funic acid -base status at birth.Design A systematic review of trials, both randomised and non-randomised, comparing epidural with systemic opioid analgesia. Population Babies of 2102 mothers taking part in trials comparing epidural with systemic analgesia in five countries. Methods From the published and unpublished figures obtained from authors, fetal pH data from 12 studies (eight randomised) (1098 babies in the epidural group þ 1004 controls) and base excess from 8 studies (four randomised) (856 epidural þ 842 controls) were subjected to random effect meta-analysis. Main outcome measures Umbilical artery pH and base excess values.Results Fetal pH was higher in the epidural than in the control group in the randomised trials (difference þ0.009, 95% CI þ0.002 to þ0.015), but when all studies were included, the difference was not significant (þ0.004, 95% CI À0.005 to þ0.014). Fetal base excess was higher in the epidural group in the four randomised studies (difference þ0.779 mEq/L, 95% CI þ0.056 to þ1.502) and in all eight studies (difference þ0.837 mEq/L, 95% CI þ0.330 to þ1.343). Conclusion Umbilical artery pH is influenced by maternal hyperventilation. Base excess is therefore a better index of metabolic acidosis after labour. Epidural analgesia is associated with improved neonatal acid -base status, suggesting that placental exchange is well preserved in association with maternal sympathetic blockade and good analgesia. Although epidural analgesia may cause maternal hypotension and fever, longer second stage of labour and more instrumental vaginal deliveries, these potentially adverse factors appear to be outweighed by benefits to neonatal acid -base status.

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“…It has been difficult to resolve because the design of fully randomized, prospective studies comparing the various methods of pain relief during labor is not easily achieved [16], Several retrospective reviews indicate that epidural analgesia is associated with longer labors and/or an in creased incidence of forceps delivery or cesarean section [17][18][19][20][21][22][23][24][25][26]. A few randomized [23; see ref.…”

Section: Effects On Progress Of Labormentioning

confidence: 99%

Lumbar Epidural Analgesia for Labor and Vaginal Delivery

Schabel¹,

Poppers²

1997

Gynecol Obstet Invest

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Lumbar epidural analgesia has become the preferred method of pain relief for labor and delivery. Proper administration of epidural analgesia offers many advantages for both mother and fetus. With the availability of various local anesthetics, opioids, and infusion techniques, the analgesia can be tailored to the specific needs of the mother, fetus, and labor. Its effect on the progress of labor remains a controversial topic subject to ongoing investigation.

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A comparison of the effect of epidural, general, and no anesthesia on funic acid-base values by stage of labor and type of delivery

Cited by 23 publications

References 18 publications

Comparison of maternal and neonatal outcomes with epidural bupivacaine plus fentanyl and ropivacaine plus fentanyl for labor analgesia

Comparison of maternal and neonatal outcomes with epidural bupivacaine plus fentanyl and ropivacaine plus fentanyl for labor analgesia

Analgesia in labour and fetal acid–base balance: a meta‐analysis comparing epidural with systemic opioid analgesia

Lumbar Epidural Analgesia for Labor and Vaginal Delivery

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