American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · May 2002
ReviewNitrous oxide for relief of labor pain: a systematic review.
A systematic review was conducted to determine the efficacy and safety of nitrous oxide for labor analgesia. Eleven randomized controlled trials with adequate control groups and outcome assessment by parturients during or shortly after the intervention were used to determine efficacy. ⋯ Nitrous oxide is not a potent labor analgesic, but it is safe for parturient women, their newborns, and health care workers in attendance during its administration. It appears to provide adequately effective analgesia for many women.
-
Am. J. Obstet. Gynecol. · May 2002
ReviewPsychological factors in the etiology and treatment of severe nausea and vomiting in pregnancy.
The assumption is frequently made that women with severe nausea and vomiting during pregnancy are transforming psychological distress into physical symptoms. Psychoanalytic theory supporting this assumption is reviewed, along with the few methodologically flawed empirical studies that have been conducted. ⋯ This implies that psychological responses can interact with the physiology of nausea and vomiting during pregnancy to exacerbate the condition. As such, psychological treatments for the symptoms of this disorder need to be further explored.
-
Am. J. Obstet. Gynecol. · May 2002
Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache.
The experience of women was sought about nausea and vomiting, its relation to olfaction, its occurrence among pregnant women with anosmia, and the potential association of hyperemesis gravidarum and migraine headache. ⋯ The frequency of nausea and vomiting, caused most often by nonpregnancy-related triggers, is high among women. In a small sample of women with congenital anosmia, nausea and vomiting of pregnancy occurred in only 1 pregnancy, suggesting that olfaction is a highly selected trigger for nausea and vomiting of pregnancy. The shared nausea and vomiting experience of hyperemesis gravidarum and migraine headache among women suggests a common mechanism, possibly based on allelic variations within the DRD2 (dopaminergic receptor) gene. Because olfactory receptors, odor types, and MHC antigens are closely integrated, and because olfactory stimuli often incite episodes of pregnancy, nausea, and vomiting, hyperemesis gravidarum, and migraine headache, these genes and their products invite further scrutiny. The pregnancy-conserving effect of PNV and the MHC antigen overlap in couples with recurrent abortion are important clues possibly relating olfaction, MHC antigens, and reproductive success or failure.
-
Am. J. Obstet. Gynecol. · May 2002
ReviewEvidence-based view of safety and effectiveness of pharmacologic therapy for nausea and vomiting of pregnancy (NVP).
Our goal was to review the safety and effectiveness of available antiemetics for treatment of nausea and vomiting of pregnancy. ⋯ Many medications, particularly H(1)-antagonists and phenothiazines, are safe and effective for treatment of varying degrees of NVP.
-
Am. J. Obstet. Gynecol. · May 2002
ReviewEpidural analgesia side effects, co-interventions, and care of women during childbirth: a systematic review.
The purpose of this article is to profile research findings targeting the intrapartum care implications of the most common side effects and co-interventions that go along with the use of epidural analgesia during labor. Randomized, controlled trials published in English from 1990 to 2000 that addressed each of the targeted side effects and 3 specified co-interventions were evaluated for inclusion in this report. Side effects such as pruritus, nausea, and hypotension during labor are common, but they are usually mild and necessitate treatment infrequently. ⋯ The use of "delayed" pushing may be an effective way to minimize the risk for difficult deliveries. Upright positioning even when confined to bed may be advantageous and desirable to women; however, additional research to determine actual outcome benefits with epidurals is needed. Implications for further research linked to epidural analgesia also include informed consent, modification of caregiving procedures, and staffing/cost issues.