Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Shoulder dystocia at vaginal delivery occurred in 0.2% of cases. Antenatal prediction of this complication was very difficult. In primigravidae in labour, delay late in the first stage was a warning sign; induction of labour, the use of regional analgesia, and forceps delivery for delay in the second stage of labour were associated with subsequent shoulder dystocia, although a cause-effect relationship was not established. The immediate maternal and fetal morbidity were high, nearly 30% of the babies suffering from a severe neural or bony injury. Forty-four per cent of the babies were beyond 41 weeks of gestation, and 70% weighed over 4,000 g. The avoidance of postmaturity by elective induction of labour at 41 weeks of gestation would significantly reduce the incidence of shoulder impaction at delivery.
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PMID:Shoulder dystocia: a study of 47 cases. 29 15

Plasma bilirubin was estimated on 690 term infants on about the 6th day of life. Perinatal factors were recorded and the results analysed. Hyperbilirubinaemia was defined as a level greater than 205 micromol/1 (12 mg/100 ml) and this was present in 20% of cases. Three factors--epidural analgesia, breast feeding, and poor weight recovery--showed highly significant associations with jaundice. The relative importance of these is discussed and compared with recent reports. Induction of labour, for reasons other than postmaturity, and a gestational age less than 39 weeks showed a slightly increased incidence of jaundice. There was no correlation with other factors tested including oxytocic drug administration. Despite the high incidence (20%) of hyperbilirubinaemia, only 2.5% infants needed treatment and none required exchange transfusion. Radical changes in obstetric management or infant feeding are not indicated.
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PMID:Factors affecting neonatal jaundice. 43 85

All the presently used local anesthetic agents in the increasingly popular modalities of obstetric regional anesthesia cross the placenta readily, governed only by two factors that the anesthesiologist has any control over (1) dosage and timing of doses and (2) uterine blood flow as it relates to the development of fetal acidosis. Uptake of a given dose of local agent from the epidural or caudal spaces may be limited with the addition of epinephrine to some extent with some drugs, but this is of little real value in the two safest drugs--bupivacaine and 2-chloroprocaine. At the doses and in the manner presently recommended, fetal intoxication with local anesthetic agent during maternal epidural analgesia should not occur in the absence of either direct intravascular injection, severe maternal hepatic disorder, marked fetal prematurity or postmaturity. The usual precautions in the exercise of regional anesthesia when applied to obstetrics render it very safe, if not the safest form of anesthesia-analgesia available.
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PMID:Placental transfer of local anesthetics. 703 31

Induction of labour is a valuable obstetric procedure, providing obstetricians with the means to intervene should the health of the fetus be in jeopardy. Currently the most common reason for induction of labour is prolonged pregnancy, as obstetricians and midwives are concerned about the risks of postmaturity such as stillbirth, intrapartum asphyxia and birth trauma which are often associated with prolonged pregnancy (Lagrew & Freeman 1986). A retrospective comparative study was carried out in a large maternity unit to identify whether or not there was clinical evidence to support a policy of elective induction for post-term pregnancy. Three years' data were extracted from the Northern Ireland Maternity System (NIMATS) by writing new queries to the system. These data on 3262 women who delivered during 1994-96 were analysed to compare the outcomes for women who were induced with women who delivered spontaneously. Although the findings from the study in many instances failed to demonstrate statistical significance between the groups they did however, have important clinical significance. For example, those women who were induced had a 5% higher rate of caesarean section, 17% higher rate of epidural analgesia and on average a greater estimated blood loss. Statistical significance was evident when the apgar scores of the infants were compared; those induced had lower Apgars at 1 minute (7. 78 in the induced group compared to 7.9 in the spontaneous group [P < 0.01]) and at 5 min (8.99 in the induced group compared to 9.05 in the spontaneous group [P < 0.02]).
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PMID:Exploring the risks associated with induction of labour: a retrospective study using the NIMATS database. Northern Ireland Maternity System. 1067