Effect of Morphine Upon Maternal Capillary Blood Oxygen and Carbon Dioxide Tension

Parenteral opioids for maternal pain management in labour

“…Eighteen studies were not randomised trials, or it was not clear that there was any random allocation to groups (Balcioglu 2007; Bredow 1992; Brelje 1966; Callaghan 1966; Cincadze 1978; Cullhed 1961; Eliot 1975; MacVicar 1960; Moore 1974; Pandole 2003; Rowley 1963; Savage 1955; Singh 2001; Soontrapa 2002; Suvonnakote 1986; Tripti 2006; Vavrinkova 2005; Volmanen 2005). In three studies it was not clear that participants were in labour (Chang 1976; Krins 1969; Tomlin 1965). In the study by Bare 1962 women did not receive an opioid.In the study by Kaltreider 1967 the focus was on a high-risk group (women in preterm labour) and post-randomisation exclusions meant that results were difficult to interpret.We excluded two studies as levels of attrition meant that results were at high risk of bias.…”

“…In three studies it was not clear that participants were in labour (Chang 1976; Krins 1969; Tomlin 1965).…”

“…This study was excluded for methodological reasons: there was no information about the number of women randomised and women who received any additional non-study medications were excluded post randomisation. Under these circumstances interpreting the findings of this study are very difficult Krins 1969 Study participants were not women in labour Li 1995 In this study 2 opioid drugs were compared (tramadol and dihydroetorphine hydrochloride). However, the drugs were administered by different routes (sublingual versus oral) and results are therefore very difficult to interpret MacVicar 1960 Not an RCT; consecutive allocation to groups.…”

Lack of Agreement on Normal Values for Fetal Scalp Blood

“…The first of these is that sampling can be carried out only in labour, when steady state conditions cannot be achieved. The second is that maternal sedation alters the levels of maternal blood gases (Krins et al, 1969). The second is that maternal sedation alters the levels of maternal blood gases (Krins et al, 1969).…”

“…For example, in a significant percentage of mothers there is a marked fall in common iliac artery blood during contractions (Bieniarz et al, 1968). The second is that maternal sedation alters the levels of maternal blood gases (Krins et al, 1969). The third is that fetal blood collection requires the mother to lie supine with her legs raised.…”