Risk factors and peripartum outcomes of failed epidural: a prospective cohort study
| العنوان: | Risk factors and peripartum outcomes of failed epidural: a prospective cohort study |
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| المؤلفون: | Gali Garmi, Carmen Bucstain, Julia Carmeli, Noah Zafran, Raed Salim, Sivan Zuarez-Easton |
| المصدر: | Archives of Gynecology and Obstetrics. 295:1119-1125 |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Gestational Age, Oxytocin, Labor Presentation, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Risk Factors, 030202 anesthesiology, Peripartum Period, medicine, Humans, Prospective Studies, Treatment Failure, 030212 general & internal medicine, Prospective cohort study, reproductive and urinary physiology, Pain Measurement, Labor, Obstetric, business.industry, Pregnancy Outcome, Obstetrics and Gynecology, General Medicine, Labor pain, female genital diseases and pregnancy complications, Analgesia, Epidural, Labor management, Logistic Models, Emergency medicine, Physical therapy, Analgesia, Obstetrical, Female, business |
| الوصف: | Awareness to rate, risk factors, and the associated peripartum outcomes of failed epidural analgesia (FEA) may improve expectations and labor management. We aimed to identify risk factors for FEA and to examine peripartum outcomes associated with failure.A prospective cohort study conducted between March 2015 and August 2015, at a single university medical center. Laboring women at ≥34 weeks, receiving epidural analgesia, were eligible. Pain was evaluated using a 0-10 cm visual analogue scale (VAS). FEA was defined as VAS score ≥5, 30 min after the loading dose. The primary outcome was to identify risk factors for FEA. In addition, second-stage duration and operative vaginal delivery rate were also examined. Univariate logistic regression and stepwise multivariate logistic regression were performed to estimate the predictors for FEA.Of all 414 women included, 35 (8.5%) had FEA. Multivariate stepwise logistic regression revealed that fetal head station 1 cm above the ischial spines (p = 0.002, adjusted OR 5.4, 95% CI 1.9-16.0), oxytocin use (p = 0.026, adjusted OR 2.8, 95% CI 1.1-6.8), and seniority of the anesthesiologist (p = 0.046, adjusted OR 0.97, 95% CI 0.93-0.99) at epidural insertion were found as significant variables associated with FEA. Second-stage duration and operative vaginal delivery rate did not differ significantly between women with failed and successful epidural.Higher fetal head station and oxytocin use may be associated with higher failure rate. Labor outcomes related to epidural use, occurred at comparable rates, among women with failed and successful epidural. |
| تدمد: | 1432-0711 0932-0067 |
| DOI: | 10.1007/s00404-017-4337-5 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::796e4c7e21c526f964d879f2be3893e6 https://doi.org/10.1007/s00404-017-4337-5 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....796e4c7e21c526f964d879f2be3893e6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14320711 09320067 |
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| DOI: | 10.1007/s00404-017-4337-5 |