Nulliparous active labor, epidural analgesia, and cesarean delivery for dystocia

American Journal of Obstetrics and Gynecology
J A BofillJ C Morrison

Abstract

Our purpose was to examine the effect of epidural analgesia on dystocia-related cesarean delivery in actively laboring nulliparous women. Active labor was confirmed in nulliparous women by uterine contractions, cervical dilatation of 4 cm, effacement of 80%, and fetopelvic engagement. Patients were randomized to one of two groups: epidural analgesia or narcotics. A strict protocol for labor management was in place. Patients recorded the level of pain at randomization and at hourly intervals on a visual analog scale. Elective outlet operative vaginal delivery was permitted. One hundred women were randomized. No difference in the rate of cesarean delivery for dystocia was noted between the groups (epidural 8%, narcotic 6%; p = 0.71). No significant differences were noted in the lengths of the first (p = 0.54) or second (p = 0.55) stages of labor or in any other time variable. Women with epidural analgesia underwent operative vaginal delivery more frequently (p = 0.004). Pain scores were equivalent at randomization, but large differences existed at each hour thereafter. The number of patients randomized did not achieve prestudy estimates. A planned interim analysis of the results demonstrated that we were unlikely to find a statis...Continue Reading

References

Nov 1, 1991·American Journal of Perinatology·J A ThorpV M Parisi
Sep 1, 1989·American Journal of Obstetrics and Gynecology·J A ThorpD A Johnston
Jan 1, 1989·European Journal of Obstetrics, Gynecology, and Reproductive Biology·T Philipsen, N H Jensen
Nov 1, 1995·Obstetrics and Gynecology·S M RaminK J Leveno
Nov 1, 1994·Obstetrics and Gynecology·H J Heyman, N Hatoum
Oct 1, 1993·American Journal of Obstetrics and Gynecology·J A ThorpJ D Yeast
Dec 1, 1996·Obstetrics and Gynecology·E LiebermanF D Frigoletto

❮ Previous
Next ❯

Citations

Jan 15, 2008·Journal de gynécologie, obstétrique et biologie de la reproduction·L ArnaoutA Mignon
Aug 24, 2004·International Journal of Obstetric Anesthesia·Terrance W Breen
Feb 25, 2000·Birth·S H HalpernB L Leighton
Mar 22, 2000·European Journal of Obstetrics, Gynecology, and Reproductive Biology·E Z ZimmerZ Weiner
Jan 24, 2003·The New England Journal of Medicine·Holger K EltzschigWilliam R Camann
Oct 26, 2000·The Journal of Obstetrics and Gynaecology Research·E W LeongY K Chan
Mar 4, 2008·Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses·Kamile Kukulu, Hafize Demirok
Feb 19, 1999·Baillière's Clinical Obstetrics and Gynaecology·M Finster, A C Santos
Jan 17, 2015·Journal of Clinical Epidemiology·Melanie Bannister-TyrrellJane B Ford
Aug 3, 2001·American Journal of Obstetrics and Gynecology·J ZhangD Schweitzer
May 16, 2002·American Journal of Obstetrics and Gynecology·Ellice Lieberman, Carol O'donoghue
May 16, 2002·American Journal of Obstetrics and Gynecology·Barbara L Leighton, Stephen H Halpern
May 16, 2002·American Journal of Obstetrics and Gynecology·Stephen B Thacker, Donna F Stroup
May 16, 2002·American Journal of Obstetrics and Gynecology·Linda J MayberryAnindya De
May 16, 2002·American Journal of Obstetrics and Gynecology·Leanne Bricker, Tina Lavender
Dec 17, 1998·American Journal of Obstetrics and Gynecology·A ClarkJ Spinnato
Feb 13, 1999·American Journal of Obstetrics and Gynecology·M K YanceyD Daniels
Apr 16, 1999·American Journal of Obstetrics and Gynecology·J ZhangR DerSimonian
Feb 29, 2000·American Journal of Obstetrics and Gynecology·L ImpeyM Robson
Apr 18, 2003·Anesthesiology Clinics of North America·Stephen H Halpern, Barbara L Leighton
Dec 24, 2013·Korean journal of anesthesiology·Hoon Jung, Kyung-Hwa Kwak
Dec 31, 2002·BJOG : an International Journal of Obstetrics and Gynaecology·Felicity ReynoldsPaul T Seed
May 25, 2011·Obstetrics and Gynecology·Elaine M FyfeUNKNOWN Screening for Pregnancy Endpoints (SCOPE) Consortium
Feb 3, 2000·Birth·E LiebermanA Cohen
May 22, 2018·The Cochrane Database of Systematic Reviews·Millicent Anim-SomuahAnna Cuthbert
May 29, 2004·Clinical Obstetrics and Gynecology·Ellice Lieberman
Mar 22, 2018·Anesthesiology·Grace LimHolger K Eltzschig
Sep 27, 2003·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·S JainV Jain
Apr 3, 2002·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Jan E DickinsonSharon F Evans
Nov 1, 2002·International Anesthesiology Clinics·Scott Segal
Jan 19, 2002·Regional Anesthesia and Pain Medicine·Brenda A BucklinJoy L Hawkins
Mar 13, 2010·Current Opinion in Anaesthesiology·Stephen H Halpern, Faraj W Abdallah
Jul 20, 2005·Acta Obstetricia Et Gynecologica Scandinavica·Wing Yee FokTze Kin Lau
Aug 15, 2001·Journal of Perinatology : Official Journal of the California Perinatal Association·K A StuartG S Meyer
Oct 8, 1999·Anesthesia and Analgesia·Y BeilinS E Abramovitz
Mar 29, 2000·Anesthesia and Analgesia·P E HessN E Oriol
Mar 29, 2000·Anesthesia and Analgesia·B S Segal, D J Birnbach
Oct 3, 2006·Current Opinion in Anaesthesiology·J L Buxbaum
Oct 3, 2006·Current Opinion in Anaesthesiology·A P Robinson, G Lyons
Nov 26, 1999·Clinical Obstetrics and Gynecology·J A Thorp
Sep 16, 2003·Clinical Obstetrics and Gynecology·David C Campbell
Sep 16, 2003·Clinical Obstetrics and Gynecology·Shiv K Sharma, Kenneth J Leveno

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

European Journal of Obstetrics, Gynecology, and Reproductive Biology
E Z ZimmerZ Weiner
International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics
E SheinerM Katz
© 2021 Meta ULC. All rights reserved