International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2025
Factors affecting womens' attitude towards labor epidural analgesia in a culturally diverse population: a prospective patient-reported outcome study.
To evaluate pregnant women's intentions to deliver with labor epidural analgesia (LEA) and identify factors influencing decision-making in a diverse population in northern Israel. ⋯ Attitudes toward LEA are shaped by culture, knowledge, prior experiences, and social support. In our cohort, the most important factors for delivering with LEA when not intending to were previous delivery with LEA and partner presence. Factors associated with not delivering with LEA were preference for natural childbirth and fear of LEA-associated side effects. Promoting evidence-based information through language-adapted platforms can further improve informed decision-making about LEA.
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Int J Obstet Anesth · Jan 2025
Patient and clinical characteristics associated with pain during cesarean delivery: a prospective single-center patient-reported outcome study.
There are multiple variables known to be associated with pain during cesarean delivery (PDCD), including patient-related factors, obstetrical and surgical factors, and anesthetic technique. The primary aim of this prospective patient-reported outcome study was to evaluate patient-related factors, including expectations and anxiety, and clinical variables associated with PDCD. ⋯ In our cohort with a high reported PDCD rate, potentially modifiable variables associated with PDCD were initial anesthetic technique and surgical duration. A concerning finding was that most patients reported some level of PDCD.
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Int J Obstet Anesth · Jan 2025
Investigating disparity in labor epidural analgesia management in black vs. white women: a retrospective case-control study (2018-2022).
Disparities in labor epidural analgesia (LEA) management could reduce maternal satisfaction and increase risk. We compared times from the first administration of breakthrough pain medication (top-up) to LEA replacement to evaluate disparities across race. ⋯ We didn't detect disparity in treatment at our institution with standardized LEA management protocols. However, Black women and those with LEA replacements were less satisfied. Future studies should evaluate the generalizability and explore interventions that improve patient satisfaction.
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Int J Obstet Anesth · Jan 2025
Urinary retention during and after labor with programmed intermittent epidural bolus (PIEB) analgesia: a prospective observational study.
This study investigates the incidence and risk factors for urinary retention during and after labor in women receiving programmed intermittent epidural bolus (PIEB) analgesia and evaluates the optimal bladder management strategy. ⋯ Women who are able to successfully void during labor have a low risk of intrapartum urinary retention. We would recommend considering catheterization every 3 to 4 hours for women who are unable to urinate spontaneously, void less than 50 ml, or experience complete motor blockade during labor.