Pain and Analgesia During Labor and Delivery Between 16 0/7 and 22 6/7 Weeks of Gestation

Hamer, Theresa; Deverman, Sarah; Nunes, Kenneth; Hofer, Jennifer; Scavone, Barbara M.

doi:10.1097/aog.0000000000001447

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…A study on Knowledge, Attitude, and Practices of labor analgesia amongst healthcare workers showed that 43.7% felt that pain relief should be administered, 14.1% believed analgesia had adverse effects on the fetus and 11.3% reported increased risk of cesarean section [ 16 , 21 ], in contrary Neuraxial analgesia in early labor did not increase the rate of cesarean delivery, and it provided better analgesia and resulted in a shorter duration of labor than systemic analgesia [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Survey on knowledge, attitude and practice of labor analgesia among health care providers at Debre Markos Comprehensive Specialized Hospital, Ethiopia 2021. A cross-sectional study

Melesse

Bayable

Simegn

et al. 2022

Annals of Medicine &Amp; Surgery

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Background Childbirth is among the most painful experiences a woman has during their childbearing years. Despite improvement in the development of standards for pain assessment and treatment, labor pain is mostly ignored especially in low and middle-income countries. Objectives To assess the knowledge, attitude, and practice of labor analgesia among health care providers at Debre-Markos comprehensive specialized hospital, Ethiopia,. Methods After ethical approval was obtained from the ethical review board, institutional-based cross-sectional study was conducted in June 2021, written consent was taken from each health care provider (HCP) before data collection, and structured self-administered questionnaires were used. The collected data were coded and analyzed using SPSS version 22. Descriptive statistics were computed to determine frequencies and percentages finally data were presented using texts, tables, and graphs. The study is registered with a research unique identifying number of 7407 found with the link address https://www.researchregistry.com/browse-the registry#home/?view_2_search = 7407&view_2_page = 1 and reported in line with STROCSS 2021. Results A total of 112 health care providers have participated with 70.5 %, 29.5% being males and females respectively. This study was found that most gynecologists/obstetricians, 75% of general practitioners, and more than half (57.1%) of integrated emergency surgery and obstetrics (IESO) have good knowledge about labor analgesia, while the majority (58.3%) of midwives found to have poor knowledge. Although 75% of general practitioners and 71.4% of IESO have a good attitude towards obstetric and labor pain management, only 55.6% of midwives and 51.2% of graduating medical students were found to have a good attitude. Among health care providers (HCP), 60.3% of graduating medical students, 75% of general practitioners, 74.1% of IESO, and most of the seniors were found to have good practice of labor analgesia. Conclusion There is a wide gap among health care providers in knowledge, attitude, and practice of labor analgesia. Training health care providers about safe, efficient, and affordable labor analgesia is crucial to improving health care.

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Section: Discussionmentioning

confidence: 99%

Survey on knowledge, attitude and practice of labor analgesia among health care providers at Debre Markos Comprehensive Specialized Hospital, Ethiopia 2021. A cross-sectional study

Melesse

Bayable

Simegn

et al. 2022

Annals of Medicine &Amp; Surgery

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“…The intelligent delivery room management system includes all living facilities and medical safety equipment, so that the parturient can feel warm during delivery and help the parturient to reduce the pain and stress reaction caused by negative emotions during delivery [ 18 ], prevent postpartum depression, and then reduce the risk of uterine weakness and prolonged labor, reduce the risk of neonatal asphyxia, and increase the natural birth rate. Because the medical equipment in use has safety risks, risk identification, risk assessment, and risk control are required [ 19 ]; the application quality evaluation of the analgesia pump should be strengthened in order to ensure the accuracy and reliability of the data collection of the intelligent delivery room management system [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Midwives’ Application of Intelligent Delivery Room Management System on Delivery Outcome

Zhang

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To investigate the impact of midwives using an intelligent delivery room management system on the outcome of deliveries. Method. A total of 100 primiparas admitted to the department of obstetrics and gynecology of our hospital from January 2019 to June 2020 were selected as the research objects. They were randomly assigned to one of two groups: control or observation. The control group got standard obstetric care. On the basis of the control group, midwives in the observation group applied the intelligent delivery room management system for delivery management. The outcomes of childbirth, postpartum anxiety, and postpartum depression were recorded and compared between the two groups. Results. The observation group’s first and second stages of labour were shorter than the control group’s ( P < 0.05 ), postpartum NRS score was lower than the control group’s ( P < 0.05 ), neonate Apgar score was higher than the control group’s ( P < 0.05 ), and the rate of vaginal delivery to caesarean section was lower than the control group’s ( P < 0.05 ). There was no statistical significance in prenatal S-AI scores between the observation group and the control group ( P > 0.05 ). After delivery, the S-AI score of the observation group was lower than that of the control group, and the comparison result was statistically significant ( P < 0.05 ). There was no significant difference in prenatal EPDS scores between the observation group and the control group ( P > 0.05 ). After delivery, the EPDS score of the observation group was lower than that of the control group, and the comparison result was statistically significant ( P < 0.05 ). Conclusion. Midwives may employ sophisticated delivery room management technologies to improve birth outcomes and reduce maternal anxiety and depression, and it is something that should be extensively promoted in clinic.

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“…However, there were few studies on the application of epidural analgesia technology in the second-trimester induced labor, and the optimal analgesic mode for the second-trimester induced labor had not been determined. [8][9][10][11] Based on the particularity of labor induction in the second trimester, and referring to the painless delivery of full-term pregnancy, we boldly tried to use epidural analgesia technology in the second-trimester induced labor, and set the analgesia time point in the cervical canal regression 60% to 70%.…”

Section: Discussionmentioning

confidence: 99%

Evaluation efficacy and safety of epidural analgesia in second-trimester induced labor: A single-center, prospective, non-randomized, controlled study

et al. 2022

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Background: Second-trimester induced labor in pregnant women was often more likely to suffer from psychological and physiological double pain. However, the analgesic management received less attention, and the optimal analgesic mode for second-trimester induced labor had not been determined. Our objective was to evaluate the feasible of epidural analgesia (EA) in second-trimester induced labor.Methods: From January 2020 to December 2021, Primipara who planned to undergo second-trimester induced labor in the First Affiliated Hospital of Yangtze University were collected. The method of labor induction was oral mifepristone + amniotic cavity injection of Ethacridine Lactate. Based on whether or not patients received epidural analgesia, which were divided into EA group (30 cases) and non-EA (NEA) group (30 cases). The primary outcome were visual analog scale (VAS) score of pain and result of follow-up, the secondary outcomes included relative clinical parameter and labor duration.Results: Vaginal induction of labor was successful in both groups. There was no statistically significant difference in VAS of pain between the two groups before analgesia (P > .05), but the VAS of pain in the EA group was significantly lower than the NEA group (P < .05) after analgesia or at delivery. The following outcomes showed no statistical difference between two groups: labor duration, postpartum hemorrhage, hemorrhage ≥ 500 mL, intrapartum injury, second days hemoglobin, C-reactive protein, antibiotic therapy days, hospitalizations days, and placenta residue (P > .05). The median hospitalization costs of EA group was 4697.5 yuan, and NEA group was 3673 yuan, the difference was statistically significant (P < .001). No adverse events related to EA occurred during hospitalization, only 3 patients showed mild lumbago and back pain after follow-up to three months postpartum, which was significantly relieved after proper rest. Conclusion:EA can significantly reduce the pain of parturients, which may be effective and safe in the second-trimester induced labor.Abbreviations: ASA = American Society of Anesthesiologists, BMI = body mass index, CRP = C-reactive protein, EA = epidural analgesia, non-EA (NEA) = no epidural analgesia, VAS = visual analog scale.

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Pain and Analgesia During Labor and Delivery Between 16 0/7 and 22 6/7 Weeks of Gestation

Abstract: Pain during induction of labor at previable gestational ages may be greater than is commonly appreciated. Neuraxial analgesia may provide more optimal pain relief for patients with higher estimated gestational age and fetal weight, particularly after 22 weeks of estimated gestational age.

Cited by 3 publications

References 9 publications

Survey on knowledge, attitude and practice of labor analgesia among health care providers at Debre Markos Comprehensive Specialized Hospital, Ethiopia 2021. A cross-sectional study

Survey on knowledge, attitude and practice of labor analgesia among health care providers at Debre Markos Comprehensive Specialized Hospital, Ethiopia 2021. A cross-sectional study

Effect of Midwives’ Application of Intelligent Delivery Room Management System on Delivery Outcome

Evaluation efficacy and safety of epidural analgesia in second-trimester induced labor: A single-center, prospective, non-randomized, controlled study

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