Document Detail


The effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review.
MedLine Citation:
PMID:  12011873     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mothers given an epidural rather than parenteral opioid labor analgesia report less pain and are more satisfied with their pain relief. Analgesic method does not affect fetal oxygenation, neonatal pH, or 5-minute Apgar scores; however, neonates whose mothers received parenteral opioids require naloxone and have low 1-minute Apgar scores more frequently than do neonates whose mothers received epidural analgesia. Epidural labor analgesia does not affect the incidence of cesarean delivery, instrumented vaginal delivery for dystocia, or new-onset long-term back pain. Epidural analgesia is associated with longer second-stage labor, more frequent oxytocin augmentation, hypotension, and maternal fever (particularly among women who shiver) but not with longer first-stage labor. Analgesic method does not affect lactation success. Epidural use and urinary incontinence are associated immediately postpartum but not at 3 or 12 months. The mechanisms of these unintended effects need to be determined to improve epidural labor analgesia.
Authors:
Barbara L Leighton; Stephen H Halpern
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  186     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-15     Completed Date:  2002-06-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S69-77     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Weill Medical College of Cornell University, New York, NY, USA. bleigh@alumni.princeton.edu
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MeSH Terms
Descriptor/Qualifier:
Analgesia, Epidural* / adverse effects
Analgesia, Obstetrical* / adverse effects
Female
Humans
Infant, Newborn
Pregnancy
Randomized Controlled Trials as Topic
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2002 May;186(5 Suppl Nature):S78-80   [PMID:  12011874 ]
J Fam Pract. 2002 Sep;51(9):786   [PMID:  12366902 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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