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II - Normal pregnancy and delivery

from Section 2 - Pregnancy

Published online by Cambridge University Press:  29 April 2019

Róisín Monteiro ,
Marwa Salman ,
Surbhi Malhotra  and
Steve Yentis
Róisín Monteiro
Affiliation:
Brighton and Sussex University Hospitals’ NHS Trust
Marwa Salman
Affiliation:
Guy’s and St. Thomas’ NHS Foundation Trust
Surbhi Malhotra
Affiliation:
Chelsea and Westminster Hospital
Steve Yentis
Affiliation:
Chelsea and Westminster Hospital
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Analgesia, Anaesthesia and Pregnancy
A Practical Guide
 , pp. 23 - 96
Publisher: Cambridge University Press
Print publication year: 2019

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References

Further reading

Richardson, J, Groen, G. Applied epidural anatomy. Contin Educ Anaesth Crit Care Pain 2005; 5: 98–100.CrossRefGoogle Scholar
Westbrook, JL. Anatomy of the epidural space. Anaesth Intensive Care Med 2012; 13: 551–4.CrossRefGoogle Scholar

Further reading

Feghali, M, Venkataramanan, R, Caritis, S. Pharmacokinetics of drugs in pregnancy. Semin Perinatol 2015; 39: 512–19.CrossRefGoogle ScholarPubMed
Jarvis, S, Nelson-Piercy, C. Common symptoms and signs during pregnancy. Obstet Gynaecol Reprod Med 2014; 24: 245–9.CrossRefGoogle Scholar

Further reading

Everett, TR, Peebles, DM. Antenatal tests of fetal wellbeing. Semin Fetal Neonatal Med 2015; 20: 138–43.CrossRefGoogle ScholarPubMed
Grivell, RM, Alfirevic, Z, Gyte, GM, Devane, D. Antenatal cardiotocography for fetal assessment. Cochrane Database Syst Rev 2015; (9): CD007863.Google ScholarPubMed
National Institute for Health and Care Excellence. Antenatal Care for Uncomplicated Pregnancies. Clinical Guideline 62. London: NICE, 2008 (updated 2017). www.nice.org.uk/guidance/CG62 (accessed December 2018).Google Scholar

Further reading

Cluver, C, Novikova, N, Hofmeyr, GJ, Hall, DR. Maternal position during caesarean section for preventing maternal and neonatal complications. Cochrane Database Syst Rev 2013; (3): CD007623.Google ScholarPubMed
Lee, A, Landau, R. Aortocaval compression syndrome: time to revisit certain dogmas. Anesth Analg 2017; 125: 1975–85.CrossRefGoogle ScholarPubMed

Further reading

National Institute for Health and Care Excellence. Intrapartum Care for Healthy Women and Babies. Clinical Guideline 190. London: NICE, 2014 (updated 2017). www.nice.org.uk/guidance/cg190 (accessed December 2018).Google Scholar
O’Sullivan, G, Liu, B, Hart, D, Seed, P, Shennan, A. Effect of food intake during labour on obstetric outcome: randomised controlled trial. BMJ 2009; 338: b784.CrossRefGoogle ScholarPubMed
Singata, M, Tranmer, J, Gyte, GM. Restricting oral fluid and food intake during labour. Cochrane Database Syst Rev 2013; (8): CD003930.Google ScholarPubMed
Sperling, JD, Dahlke, JD, Sibai, BM. Restriction of oral intake during labour: whither are we bound? Am J Obstet Gynecol 2016; 214: 592–6.CrossRefGoogle ScholarPubMed

Further reading

Henderson, E, Mackillop, L. Prescribing in pregnancy and during breast feeding: using principles in clinical practice. Postgrad Med J 2011; 87: 349–54.CrossRefGoogle ScholarPubMed
Howell, PR, Madej, T. Administration of drugs outside of product licence: awareness and current practice. Int J Obstet Anesth 1999; 8: 30–6.CrossRefGoogle ScholarPubMed
World Health Organization. Breastfeeding and Maternal Medication: Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Geneva: WHO, 2002. http://whqlibdoc.who.int/hq/2002/55732.pdf (accessed December 2018).Google Scholar

Further reading

Griffiths, SK, Campbell, JP. Placental structure, function and drug transfer. Contin Educ Anaesth Crit Care Pain 2015; 15: 84–89.CrossRefGoogle Scholar
Littleford, J. Effects on the fetus and newborn of maternal analgesia and anesthesia: a review. Can J Anesth 2004; 51: 586–609.CrossRefGoogle ScholarPubMed

Further reading

Nursing and Midwifery Council. Standards for Medicines Management. London: NMC, 2007 (updated 2015). www.nmc.org.uk/standards/standards-for-post-registration/standards-for-medicines-management (accessed December 2018).Google Scholar
Royal Pharmaceutical Society. Safe and Secure Handling of Medicines: a Team Approach. London: RPS, 2005 (updated 2018). www.rpharms.com/resources/professional-standards/safe-and-secure-handling-of-medicines (accessed December 2018).Google Scholar

Further reading

Association of Anaesthetists of Great Britain and Ireland. Management of Severe Local Anaesthetic Toxicity. London: AAGBI, 2010. www.aagbi.org/sites/default/files/la_toxicity_2010_0.pdf (accessed December 2018).Google Scholar
Bern, S, Weinberg, G. Local anesthetic toxicity and lipid resuscitation in pregnancy. Curr Opin Anaesthesiol 2011; 24: 262–7.CrossRefGoogle ScholarPubMed

Further reading

Ferguson, E, Owen, P. The second stage of labour. Hosp Med 2003; 64: 210–13.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Intrapartum Care for Healthy Women and Babies. Clinical Guideline 190. London: NICE, 2014 (updated 2017). www.nice.org.uk/guidance/cg190 (accessed December 2018).Google Scholar
Steer, P, Flint, C. Physiology and management of normal labour. BMJ 1999; 318: 793–6.CrossRefGoogle ScholarPubMed

Further reading

Hinshaw, K, Ullal, A. Peripartum and intrapartum assessment of the fetus. Anaesth Intensive Care Med 2010; 11: 324–32.CrossRefGoogle Scholar
National Institute for Health and Care Excellence. Intrapartum Care for Healthy Women and Babies. Clinical Guideline 190. London: NICE, 2014 (updated 2017). www.nice.org.uk/guidance/cg190 (accessed December 2018).Google Scholar
Viswanatha, RK, Talaulikar, VS, Arulkumaran, S. Intrapartum fetal surveillance. Obstet Gynaecol Reprod Med 2017; 27: 363–72.CrossRefGoogle Scholar

Further reading

Bohren, MA, Hofmeyr, GJ, Sakala, C, Fukuzawa, RK, Cuthbert, A. Continuous support for women during childbirth. Cochrane Database Syst Rev 2017; (7): CD003766.Google ScholarPubMed
Cluett, ER, Burns, E, Cuthbert, A. Immersion in water during labour and birth. Cochrane Database Syst Rev 2018; (5): CD000111.Google ScholarPubMed
Dowswell, T, Bedwell, C, Lavender, T, Neilson, JP. Transcutaneous electrical nerve stimulation (TENS) for pain relief in labour. Cochrane Database Syst Rev 2009; (2): CD007214.Google ScholarPubMed
Madden, K, Middleton, P, Cyna, AM, Matthewson, M, Jones, L. Hypnosis for pain management during labour and childbirth. Cochrane Database Syst Rev 2016; (5): CD009356.Google ScholarPubMed
National Institute for Health and Care Excellence. Intrapartum Care for Healthy Women and Babies. Clinical Guideline 190. London: NICE, 2014 (updated 2017). www.nice.org.uk/guidance/cg190 (accessed December 2018).Google Scholar

Further reading

Likis, FE, Andrews, JC, Collins, MR, et al. Nitrous oxide for the management of labor pain: a systematic review. Anesth Analg 2014; 118: 153–67.CrossRefGoogle ScholarPubMed
Richardson, MG, Lopez, BM, Baysinger, CL. Should nitrous oxide be used for labouring patients? Anesthesiol Clin 2017; 35: 125–43.CrossRefGoogle Scholar
Sutton, CD, Butwick, AJ, Riley, E, Carvalho, B. Nitrous oxide for labor analgesia: utilization and predictors of conversion to neuraxial analgesia. J Clin Anaesth 2017; 40: 40–5.CrossRefGoogle ScholarPubMed

Further reading

Littleford, J. Effects on the fetus and newborn of maternal analgesia and anesthesia: a review. Can J Anaesth 2004; 51: 586–609.CrossRefGoogle ScholarPubMed
Phillips, SN, Fernando, R, Girard, T. Parenteral opioid analgesia: does it still have a role? Best Pract Res Clin Anaesthesiol 2017; 31: 3–14.CrossRefGoogle ScholarPubMed
Smith, LA, Burns, E, Cuthbert, A. Parenteral opioids for maternal pain management in labour. Cochrane Database Syst Rev 2018; (6): CD007396.Google ScholarPubMed

Further reading

Hinova, A, Fernando, R. Systemic remifentanil for labor analgesia. Anesth Analg 2009; 109: 1925–9.CrossRefGoogle ScholarPubMed
Muchatuta, NA, Kinsella, SM. Remifentanil for labour analgesia: time to draw breath? Anaesthesia 2013; 68: 231–5.CrossRefGoogle ScholarPubMed
Schnabel, A, Hahn, N, Broscheit, J, et al. Remifentanil for labour analgesia: a meta-analysis of randomised controlled trials. Eur J Anaesthesiol 2012; 29: 177–85.CrossRefGoogle ScholarPubMed
Van de Velde, M, Carvalho, B. Remifentanil for labor analgesia: an evidence-based narrative review. Int J Obstet Anesth 2016; 25: 66–74.CrossRefGoogle ScholarPubMed

Further reading

Anim-Somuah, M, Smyth, RM, Cyna, AM, Cuthbert, A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev 2018; (5): CD000331.Google ScholarPubMed
Loubert, C, Hinova, A, Fernando, R. Update on modern neuraxial analgesia in labour: a review of the literature of the last 5 years. Anaesthesia 2011; 66: 191–212.CrossRefGoogle ScholarPubMed
Sng, BL, Sia, ATH. Maintenance of epidural labour analgesia: the old, the new and the future. Best Pract Res Clin Anaesthesiol 2017; 31: 15–22.CrossRefGoogle ScholarPubMed

Further reading

Camorcia, M. Testing the epidural catheter. Curr Opin Anaesthesiol 2009; 22: 336–40.CrossRefGoogle ScholarPubMed
Guay, J. The epidural test dose: a review. Anesth Analg 2006; 102: 921–9.CrossRefGoogle ScholarPubMed

Further reading

Cohn, J, Moaveni, D, Sznol, J, Ranasinghe, J. Complications of 761 short-term intrathecal macrocatheters in obstetric patients: a retrospective review of cases over a 12-year period. Int J Obstet Anesth 2016; 25: 30–6.CrossRefGoogle Scholar
Loubert, C, Hinova, A, Fernando, R. Update on modern neuraxial analgesia in labour: a review of the literature of the last 5 years. Anaesthesia 2011; 66: 191–212.CrossRefGoogle ScholarPubMed
Palmer, CM. Continuous spinal anesthesia and analgesia in obstetrics. Anesth Analg 2010; 111: 1476–9.CrossRefGoogle ScholarPubMed

Further reading

Groden, J, Gonzalez-Fiol, A, Aaronson, J, Sachs, A, Smiley, R. Catheter failure rates and time course with epidural versus combined spinal–epidural analgesia in labor. Int J Obstet Anesth 2016; 26: 4–7.CrossRefGoogle ScholarPubMed
Heesen, M, Weibel, S, Klimek, M, et al. Effects of epidural volume extension by saline injection on the efficacy and safety of intrathecal local anaesthetics: systematic review with meta-analysis, meta-regression and trial sequential analysis. Anaesthesia 2017; 72: 1398–411.CrossRefGoogle ScholarPubMed
Simmons, SW, Taghizadeh, N, Dennis, AT, Hughes, D, Cyna, AM. Combined spinal–epidural versus epidural analgesia in labour. Cochrane Database Syst Rev 2012; (10): CD003401.Google ScholarPubMed

Further reading

American Society of Anesthesiologists Task Force on Neuraxial Opioids. Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration. An updated report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology 2016; 124: 535–52.Google Scholar
Armstrong, S, Fernando, R. Side effects and efficacy of neuraxial opioids in pregnant patients at delivery: a comprehensive review. Drug Saf 2016; 39: 381–99.CrossRefGoogle ScholarPubMed
Kwok, S, Wang, H, Sng, BL. Post-caesarean analgesia. Trends Anaesth Crit Care 2014; 4: 189–94.CrossRefGoogle Scholar
Marroquin, B, Feng, C, Balofsky, A, et al. Neuraxial opioids for post-cesarean delivery analgesia: can hydromorphone replace morphine? A retrospective study. Int J Obstet Anesth 2017; 30: 16–22.CrossRefGoogle ScholarPubMed
Sultan, P, Halpern, SH, Pushpanathan, E, Patel, S, Carvalho, B. The effect of intrathecal morphine dose on outcomes after elective cesarean delivery: a meta-analysis. Anesth Analg 2016; 123: 154–64.CrossRefGoogle ScholarPubMed

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