Biomaterial Database

Lumbar epidural analgesia in labour: relation to fetal malposition and instrumental delivery. 1977

I J Hoult, and A H MacLennan, and L E Carrie

The incidence of instrumental delivery and malposition immediately before delivery was compared in patients who were given lumbar epidural analgesia and those who were not. Instrumental delivery was five times more common and a malposition of the fetal head was more than three times as common in the epidural group as in women who did not receive regional analgesia. Similar incidences were found even when the epidural was electively chosen before labour in the absence of medical indications. The instrumental delivery rate was affected by parity, the length of the second stage of labour, and the return of sensation by the second stage but not by other factors studied. The high incidence (20%) of malposition associated with epidural analgesia was not affected by any of the factors studied. The psychological and physical disadvantages of malposition and instrumental delivery have yet to be assessed. In the meantime, when there are no medical indications for epidural analgesia, the advantages of pain relief should be weighed against those of a normal spontaneous delivery.

UI	MeSH Term	Description	Entries
D007744	Obstetric Labor Complications	Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.	Complications, Labor,Labor Complications,Complication, Labor,Complication, Obstetric Labor,Complications, Obstetric Labor,Labor Complication,Labor Complication, Obstetric,Labor Complications, Obstetric,Obstetric Labor Complication
D007746	Labor Presentation	The position or orientation of the FETUS at near term or during OBSTETRIC LABOR, determined by its relation to the SPINE of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the NECK.	Fetal Presentation,Presentation, Fetal,Fetal Malpresentation,Fetal Malpresentations,Malpresentation, Fetal,Presentation, Labor
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D005113	Extraction, Obstetrical	Extraction of the fetus by means of obstetrical instruments.	Extraction, Obstetric,Extractions, Obstetric,Extractions, Obstetrical,Obstetric Extraction,Obstetric Extractions,Obstetrical Extraction,Obstetrical Extractions
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000767	Anesthesia, Epidural	Procedure in which an anesthetic is injected into the epidural space.	Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D000773	Anesthesia, Obstetrical	A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.	Anesthesia, Gynecological,Anesthesia, Obstetric,Gynecologic Anesthesia,Paracervical Block,Anesthesia, Gynecologic,Block, Paracervical,Blocks, Paracervical,Gynecological Anesthesia,Obstetric Anesthesia,Obstetrical Anesthesia,Paracervical Blocks