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Nulliparous women with low cervical dilation more likely to need more anaesthetic interventions

01 Nov 2019

A single injection of spinal anaesthesia appears to be enough for multiparous women undergoing spontaneous labour with more advanced cervical dilation, a recent study has found.

Researchers retrospectively reviewed electronic medical records of 428 women (median age, 30 years) who received spinal analgesic blocks for labour. The primary outcome was the need for an additional anaesthetic intervention after the first administration of analgesia. Spinal, epidural and general anaesthesia, as well as intravenous sedation, were counted.

Sixty instances of required additional anaesthetic intervention were reported, resulting in an overall rate of 14.0 percent. The median time to additional administration was 115 minutes. These patients showed significantly longer time to delivery than their counterparts who did not require any additional anaesthetics (222 vs 48 minutes; p<0.001).

Multivariable logistic regression analysis found that higher age (odds ratio [OR] per 5 years, 1.41, 95 percent CI, 1.04–1.90; p=0.025), nulliparity (OR, 3.33, 1.72–6.43; p<0.001) and having low cervical dilation (OR per 1 cm, 0.87, 0.76–1.00; p=0.045) were all significant predictors for needing additional anaesthetic interventions.

Complications were rare (n=9; 2.1 percent) and were limited to postdural puncture headaches. Of those who developed the side effect, more than half (n=5; 55.6 percent) received successful epidural blood patches. There were no reports of neurologic or bleeding complications, and none of the participating women required treatment for pruritus.

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Most Read Articles
20 Jun 2020
The Lundbeck Neuroscience Symposium was held at Sofitel KL Damansara over 2 days, with extensivediscussions on the management of various mental illnesses. The second day of the symposiumaddressed the topic of schizophrenia management, focusing on treatment goals, the rationale forpartial dopamine D(2) receptor agonism and the use of long-acting injectable (LAI) antipsychotics topromote adherence.
Pearl Toh, 5 days ago
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
4 days ago
Patients with psoriatic arthritis (PsA) often suffer from liver abnormalities, which are associated with higher body mass index (BMI), daily consumption of alcohol, more severe disease, and some therapies, according to a recent study.
Christina Lau, 2 days ago

Pembrolizumab in combination with chemotherapy significantly improves progression-free survival (PFS) vs chemotherapy alone in patients with previously untreated, locally recurrent inoperable or metastatic triple-negative breast cancer (TNBC), results of the KEYNOTE-355 study have shown.