Intrapartum Analgesia—Have Women’s Preferences Changed over the Last Decade?

Jodzis, Agnieszka; Czajkowski, Krzysztof; Różańska-Walędziak, Anna

doi:10.3390/medicina58010087

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Another Polish study confirmed the high percentage of women expecting anesthesia for childbirth over the past decade. There was no difference between 2010 and 2020 in the percentage of woman who wanted analgesia during labor, 67.9% and 73.9%, respectively [ 47 ]. Notably, a study conducted in Australia demonstrated a large discrepancy between perception and actual knowledge about analgesia during labor.…”

Section: Discussionmentioning

confidence: 99%

Women’s Knowledge about Pharmacological and Non-Pharmacological Methods of Pain Relief in Labor

et al. 2023

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This study aimed to assess knowledge about non-pharmacological pain-relief methods in labor among women who have given birth at least once. This cross-sectional study was conducted using an online survey among 466 adult women. The minimum sample size was estimated based on the number of labor admissions in the year before the study in Poland. The survey included questions about respondents’ sociodemographics and knowledge of pain-relief methods. The knowledge score was calculated using the sum of correct answers. Non-parametric Spearman’s correlation, Kruskal–Wallis and Wilcoxon variance tests were used. Antenatal classes (313/68.9%) and the Internet (248/54.6%) were the most common sources of knowledge. The most popular pharmacological pain-relief methods included epidural anesthesia (386/85.0%) and nitrous oxide (301/66.3%). Massage and breathing techniques were the most commonly known non-pharmacological methods (405/89.2% and 400/88.1%, respectively). The knowledge score about non-pharmacological methods was significantly higher as compared to the pharmacological methods score (rc = 0.85; p < 0.001). Respondents’ age correlated with knowledge about non-pharmacological methods (rs = −0.10,p = 0.026) but did not correlate with knowledge about pharmacological methods. Educational level correlated with knowledge about pharmacological (rs = −0.13,p = 0.007) and non-pharmacological (rs = 0.14, p = 0.003) methods concerning pain relief in labor. No correlation was found between respondents’ knowledge and gravidity, number of vaginal or cesarean deliveries, and hospital referral levels for previous deliveries. Our findings support the need to implement educational programs to increase evidence-based knowledge about pain-relief methods during labor in women.

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Section: Discussionmentioning

confidence: 99%

Women’s Knowledge about Pharmacological and Non-Pharmacological Methods of Pain Relief in Labor

et al. 2023

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“…A recent study showed that, although intravenous anesthesia provides a satisfactory experience, the use of epidural analgesia provides better analgesia and satisfaction than patient-controlled analgesia with Remifentanil [ 45 ]. Additionally, recently, a high proportion of Polish women chose epidural analgesia during labor over other pharmacological and non-pharmacological pain-relief methods [ 46 ]. The reason why Polish patients tend to have an increased demand for choosing epidural or intravenous analgesia might be a lack of proper counseling about the possible non-pharmacological methods of pain relief during labor given by healthcare professionals.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Misoprostol Vaginal Inserts for Induction of Labor in Women with Very Unfavorable Cervices

Socha

Flis

Wartęga

et al. 2023

JCM

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Background: The purpose of the present study was to evaluate the effectiveness of a misoprostol vaginal insert as an induction-of-labor (IOL) agent in women with an unfavorable cervix (Bishop score < 2) in achieving vaginal delivery (VD) within 48 h, depending on the gestational week, with particular emphasis on the cesarean section (CS) percentage, intrapartum analgesia application and possible side effects, such as tachysystole ratio. Methods: In this retrospective observational study involving 6000 screened pregnant patients, 190 women (3%) fulfilled the study inclusion criteria and underwent vaginal misoprostol IOL. The pregnant women were collected into three groups: patients who delivered at up to 37 weeks of gestation (<37 Group)—42 patients; patients who delivered between 37 and 41 weeks of gestation (37–41 Group)—76 patients; and patients who delivered after 41 weeks of gestation (41+ Group)—72 patients. The outcomes included time to delivery and mode of delivery, rate of tachysystole, need for intrapartum analgesia, and need for oxytocin augmentation. Results: Most of the patients delivered vaginally (54.8% in <37 Group vs. 57.9% in 37–41 Group vs. 61.1% in 41+ Group). A total of 89.5% (170/190) of patients delivered within 48 h (<37 Group—78.6% vs. 37–41 Group—89.5% vs. 41+ Group—95.8%). Statistical significance was demonstrated for the increased rate of vaginal deliveries and shortened time to delivery in the 41+ weeks group (p = 0.0026 and p = 0.0038). The indications for cesarean section were as follows: abnormal CTG pattern vs. lack of labor progression: 42.1% vs. 57.9% in <37 Group, 59.4% vs. 40.6% in 37–41 Group and 71.4% vs. 28.6% in 41+ Group. Statistical significance was demonstrated for the increased rate of abnormal CTG patterns as cesarean section indications in the 41+ Group (p = 0.0019). The need for oxytocin augmentation in each group was: 35.7% in <37 Group vs. 19.7% in 37–41 Group vs. 11.1% in 41+ Group. Statistical significance was shown for decreased need for oxytocin augmentation in +41 Group (p = 0.0016). The need for intrapartum anesthesia, depending on the group, was: 78.6% in <37 Group vs. 82.9% in 37–41 Group vs. 83.3% in 41+ Group. Statistical significance was demonstrated for increased need for intrapartum anesthesia application during labor in +41 Group (p = 0.0018). The prevalence of hyperstimulation was similar in all three groups (4.8% vs. 7.9% vs. 5.6% p > 0.05). Conclusions: The misoprostol vaginal regimen for IOL used in our study is effective in achieving vaginal delivery within 48 h. In post-term women, the use of this regimen is characterized by an increased rate of vaginal deliveries, a shorter time to delivery and a lower need for oxytocin.

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“…Questionnaires including incorrect data were excluded from further analysis. The materials and methods for this study were also described in previous publications [ 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

Does Obesity Influence Women’s Decision Making about the Mode of Delivery?

Różańska-Walędziak

2022

JCM

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Introduction: The ratio of cesarean deliveries (CDs) has been increasing worldwide, with a growing problem of cesarean delivery on maternal request (CDMR) and an alarmingly increasing rate of CD in the private sector. There are numerous factors influencing women’s preferences for the mode of delivery and their opinion about shared decision making (SDM). Material and method: The study was designed as an online survey, filled in by 1040 women. The questionnaire included questions about women’s preferences for the mode of delivery, their opinions about CDMR and the process of decision making regarding the mode of delivery. Results: There were no statistically significant differences found between women with a BMI ≤ 25 kg/m2 and >25 kg/m2, nor with a BMI ≤ 30 kg/m2 and >30 kg/m2, on the subject of the preferred method of delivery, and the opinion regarding SDM and CDMR without medical indications. More than 85% of women in all groups, who preferred CD as the mode of delivery, wanted to have CDMR. Conclusion: We have not found obesity and overweight to be a factor influencing women’s preferred mode of delivery, their opinion about SDM and their preference for CDMR without medical indications. However, the sample size of women with morbid obesity with a BMI ≥ 35 kg/m2 was too small for the results to be considered significant in this group, and it will therefore be subject to further studies.

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Intrapartum Analgesia—Have Women’s Preferences Changed over the Last Decade?

Cited by 4 publications

References 23 publications

Women’s Knowledge about Pharmacological and Non-Pharmacological Methods of Pain Relief in Labor

Women’s Knowledge about Pharmacological and Non-Pharmacological Methods of Pain Relief in Labor

The Efficacy of Misoprostol Vaginal Inserts for Induction of Labor in Women with Very Unfavorable Cervices

Does Obesity Influence Women’s Decision Making about the Mode of Delivery?

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