Epidural Analgesia and Severe Perineal Laceration in a Community-based Obstetric Practice

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Epidural analgesia and severe perineal laceration in a community-based obstetric practice.

BACKGROUND This study assessed whether epidural analgesia was an independent risk factor for severe perineal laceration. METHODS A retrospective cohort study analyzed 2,759 patients at St. Francis Regional Medical Center who had vertex, spontaneous or induced, singleton, live, vaginal deliveries of neonates of at least 36 weeks' gestation. Patients with diabetes or severe cardiac disease were...

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Severe Perineal Lacerations in Obstetric Practice: The Effect of Institutional Practice Guidelines on Repair Failures in a Single Centre

Background. There is a high incidence of failure after repair of severe perineal lacerations (SPLs). A tertiary referral hospital in the Caribbean introduced guidelines in an attempt to improve outcomes. We performed an audit of SPL repairs at this centre in an attempt to determine the effect on repair failure. Methods. All patients with SPL repairs between November 1, 2007, and December 30, 20...

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Epidural analgesia in an obstetric patient with Klippel-Trenaunay syndrome.

We describe the use of epidural analgesia for vaginal delivery of a parturient with Klippel-Trenaunay syndrome in whom the use of repeated magnetic resonance imaging during her obstetric care allowed us to see deep haemangiomata. This also allowed the safe sitting of an epidural catheter at L1-2 to provide analgesia for labour and delivery. Klippel-Trenaunay syndrome and the anaesthetic implica...

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Incidence of epidural hematoma, infection, and neurologic injury in obstetric patients with epidural analgesia/anesthesia.

Of the 4 million annual births in the United States, 2.4 million involve epidural analgesia. Serious adverse events are rare but are important in young women. Robust estimates for the risk of harm are not available. Data for superficial and deep infections, hematoma, and transient and permanent neurologic injury were obtained from studies reporting adverse events with obstetric epidural analges...

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Uneventful epidural analgesia in a patient with severe thrombocytopenia.

Epidural analgesia is the most effective method for analgesia in labor. It has, however, contraindications and carries many serious side effects. Though coagulopathy is an absolute contraindication for epidural and axial blocks, yet there are no absolute limits for platelet counts that stand in the way of providing epidural analgesia. In a patient who is writhing in pain due to severe uterine c...

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ژورنال

عنوان ژورنال: The Journal of the American Board of Family Medicine

سال: 2003

ISSN: 1557-2625,1558-7118

DOI: 10.3122/jabfm.16.1.1