Analgesia for forceps delivery

Nikpoor, Payam; Watson-Jones, Rae

doi:10.1002/14651858.cd008878

Cited by 6 publications

(9 citation statements)

References 6 publications

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“…(3) A instrumental vaginal delivery is understood as one that requires forceps or use of a vacuum extractor to assist in the expulsive period, (10) and can be indicated by fetal or maternal conditions during the second stage of labor. (11) It is an important resource for minimizing risks, such as in cases of fetal distress, and may prevent fetal morbidity or death. (10) In contrast, it has been associated with a higher risk of fetal morbidity and mortality, as well as maternal morbidities.…”

Section: Introductionmentioning

confidence: 99%

O uso de analgesia farmacológica influencia no desfecho de parto?

et al. 2017

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Objective: To investigate the association between pharmacological analgesia and childbirth outcomes. Methods: A cross-sectional study using a representative sample of childbirth performed in 2013, at a maternity hospital in Belo Horizonte, Minas Gerais. Data from 978 childbirths were included, excluding elective cesareans. The main exposure was the use of pharmacological analgesia during labor, with the outcome classified as vaginal, instrumental vaginal, or cesarean delivery. The association between analgesia and childbirth outcomes was assessed using multinomial logistic regression to obtain Odds Ratio (OR) estimates with their respective 95% confidence intervals. The final model was adjusted for the woman's age, number of previous births, presence of companion or doula, and cervical dilatation at the time of analgesia. Results: Among the total number of births, 87.1% were vaginal and 12.9% were cesarean. The prevalence of the use of pharmacological analgesia was 34.2%, and delivery with instrumentation was 8.4%. About 70% of the women had a normal risk pregnancy. Even after adjusting for confounding variables, the use of analgesia increased the chance of delivery with instrumentation by 3.5 times (p<0.0001); for women with high-risk pregnancies, this increase was even higher (OR=4.62; p<0.0001). There was no association between analgesia and cesarean section (p=0.320). Conclusion: The use of pharmacological analgesia modifies the outcome of childbirth, increasing the chances of delivery with instrumentation, especially in women with high-risk pregnancies. In this context, it is important to guide women about the potential risks and benefits of analgesia so they may make a safe choice. ResumoObjetivo: Investigar associação entre analgesia farmacológica e desfechos do parto. Métodos: Estudo transversal que utilizou amostra representativa dos partos realizados em 2013, em uma maternidade de Belo Horizonte, Minas Gerais. Foram incluídos dados de 978 partos, excluindo-se as cesarianas eletivas. A exposição principal foi o uso de analgesia farmacológica durante o trabalho de parto e o desfecho classificado como parto vaginal, vaginal instrumentalizado e cesariana. Verificou-se a associação entre analgesia e os desfechos do parto por meio de regressão logística multinominal para obter as estimativas de Odds Ratio (OR) com seus respectivos intervalos de 95% de confiança, e o modelo final foi ajustado por idade da mulher, número de partos anteriores, presença de acompanhante ou doula e dilatação cervical no momento da analgesia. Resultados: Do total de nascimentos, 87,1% foram vaginais e 12,9% cesariana. A prevalência do uso de analgesia farmacológica foi 34,2% e do parto instrumentalizado de 8,4%. Cerca de 70% das mulheres tiveram gestação de risco habitual. Mesmo após ajuste por confundidores, o uso da analgesia aumentou em 3,5 vezes a chance de parto instrumentalizado (p<0,0001) e para as mulheres com gestação de alto risco esse aumento foi ainda superior (OR=4,62; p<0,0001). Não houve associação do uso da ...

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Section: Introductionmentioning

confidence: 99%

O uso de analgesia farmacológica influencia no desfecho de parto?

et al. 2017

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“…Paracetamol has a good safety record in the postnatal period and is used regularly in postoperative pain. 135 Evidence level 1++…”

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confidence: 99%

Assisted Vaginal Birth

Murphy¹,

Strachan²,

Bahl³

et al. 2020

BJOG

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Ensure obstetric trainees receive appropriate training in vacuum and forceps birth, including theoretical knowledge, simulation training and clinical training under direct supervision. [New 2020] P Competency should be demonstrated before conducting unsupervised births. [New 2020] P Complex assisted vaginal births should only be performed by experienced operators or under the direct supervision of an experienced operator. D Who should supervise assisted vaginal birth? An experienced operator, competent at midpelvic births, should be present from the outset to supervise all attempts at rotational or midpelvic assisted vaginal birth. D Where should assisted vaginal birth take place? RCOG Green-top Guideline No. 26 e73 of e112 ª 2020 Royal College of Obstetricians and Gynaecologists P Discontinue vacuum-assisted birth if there have been two 'pop-offs' of the instrument. Less experienced operators should seek senior support after one 'pop-off' to ensure the woman has the best chance of a successful assisted vaginal birth.

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“…Ultimately, nine Cochrane reviews met the inclusion criteria and were included for extraction. [12][13][14][25][26][27][28][29][30] The nine Cochrane reviews were published between 2012 and 2018, and ranged in size from four to 70 trials. These reviews included the use of epidural, combined spinalepidural, local anaesthetic nerve blocks, parenteral opioids, non-opioid drugs (such as non-steroidal anti-inflammatory drugs [NSAIDs]; paracetamol; antispasmodics; sedatives and antihistamines), inhaled analgesia, patient-controlled analgesia with remifentanil, and analgesia for forceps delivery.…”

Section: Resultsmentioning

confidence: 99%

“…These reviews included the use of epidural, combined spinalepidural, local anaesthetic nerve blocks, parenteral opioids, non-opioid drugs (such as non-steroidal anti-inflammatory drugs [NSAIDs]; paracetamol; antispasmodics; sedatives and antihistamines), inhaled analgesia, patient-controlled analgesia with remifentanil, and analgesia for forceps delivery. [12][13][14][25][26][27][28][29][30] Within these nine Cochrane reviews, a total of 227 unique trials were identified. These trials were conducted between 1958 and 2018, and sample sizes ranged from eight to 12 793 participants.…”

Section: Resultsmentioning

confidence: 99%

Outcomes to measure the effects of pharmacological interventions for pain management for women during labour and birth: a review of systematic reviews and randomised trials

Tan

Wilson

Eghrari

et al. 2021

BJOG

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Background Pharmacological pain management options can relieve women's pain during labour and birth. Trials of these interventions have used a wide variety of outcomes, complicating meaningful comparisons of their effects. To facilitate better assessment of the effectiveness of labour pain management in trials and meta-analyses, consensus about key outcomes and the development of a core outcome set is essential.Objective To identify all outcomes used in studies of pharmacological pain management interventions during labour and birth.Design A review of systematic reviews and their included randomised controlled trials was undertaken.Search strategy Cochrane CENTRAL was searched to identify all Cochrane systematic reviews describing pharmacological pain management options for labour and birth. Search terms included 'pain management', 'labour' and variants, with no limits on year of publication or language.Selection criteria Cochrane reviews and randomised controlled trials contained within these reviews were included, provided they compared a pharmacological intervention with other pain management options, placebo or no treatment.Data collection and analysis All outcomes reported by reviews or trials were extracted and tabulated, with frequencies of individual outcomes reported.Main results Nine Cochrane reviews and 227 unique trials were included. In total, 146 unique outcomes were identified and categorised into maternal, fetal, neonatal, child, health service, provider's perspective or economic outcome domains.Conclusions Outcomes of pharmacological pain management interventions during labour and birth vary widely between trials. The standardisation of trial outcomes would permit the assessment of meta-analyses for best clinical practice.

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Analgesia for forceps delivery

Cited by 6 publications

References 6 publications

O uso de analgesia farmacológica influencia no desfecho de parto?

O uso de analgesia farmacológica influencia no desfecho de parto?

Assisted Vaginal Birth

Outcomes to measure the effects of pharmacological interventions for pain management for women during labour and birth: a review of systematic reviews and randomised trials

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