J Gynecol Obst Bio R
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The authors present a study of 20 cases of epidural obstetrical analgesia. A Bupivacaine-Fentanyl mixture was given by continuous flow to bring about this analgesia. After an initial injection of 10 ml (9 ml of 0.25% Bupivacaine and 0.05 mg Fentanyl), a mixture of 45 ml of 0.25% Bupivacaine and 0.25 mg Fentanyl was perfused into the epidural space using an electronic pump syringe, delivering at a rate of 5 ml/hr. ⋯ There are no detectable changes in the haemodynamic parameters in either the mothers or the fetuses and no depression of maternal respiration was found. In each case the Apgar score was 10 after 5 minutes. In summary, the use of an electronic pump syringe to deliver a Bupivacaine-Fentanyl mixture in obstetrical labour is a great improvement in analgesia without any secondary effects in the mother and child.
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J Gynecol Obst Bio R · Jan 1985
Comparative Study[Puerperal urinary tract infections: role of epidural analgesia, a scheme for prevention].
Epidural analgesia often leads to an increase in the number of catheterisations because of the modifications that result in the physiology of the urinary tract. These catheterisations lead to lower urinary tract infections. Our study on 312 patients shows that: under epidural analgesia it is necessary to carry out catheterisation 3.6 times more frequently; urinary tract infections are 2.6 times more frequent under epidural analgesia; the incidence of urinary tract infection multiplies in accordance with the number of catheterisations whether there has been epidural analgesia or not; a single prophylactic dose of 3 g of amoxycillin can avoid three-quarters of these infections.
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J Gynecol Obst Bio R · Jan 1984
[Cesarean section preceding the 34th week of amenorrhea: maternal and fetal repercussions at the western university hospitals. Regional survey or 383 cesarean sections and 436 newborn infants out of 86,116 births in 5 years].
This statistical enquiry carried out in a region of France by the University Hospital Services in Obstetrics and voluntarily devoid of bibliographical references, deals with a group that are particularly pathological and thus probably explains the seriousness of the prognosis for the newborn and the frequency of maternal morbidity following these early operations. 15% of serious maternal complications with severe neonatal pathology which was often heavy and responsible for the death of the fetus in 22.4% of the cases and the late sequelae in the newborn in more than 10% of cases, mad it important to seek for the inevitable link between the pathology and the length of gestation at the time of the operation. Only one in three children were alive without any sequelae after Caesarean carried out between 28 and 31 weeks, but more than 80% were alive when the operation was performed at 34 weeks. ⋯ In view of the poor statistical results that have been analysed, early Caesarean section for fetal pathology and particularly for fetal distress when there is no adequate sophisticated means of resuscitating the baby should be lowered to the minimum possible figure. The comparative study of the notes shows that pathological conditions apparently similar to one another lead to occasions for carrying out very early Caesarean section, and also show that the outlook is different from the point of view of the immediate prognosis and a late prognosis for the newborn infant in view of the delay that has occurred before extracting the baby and of the facilities available to resuscitate the baby.
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J Gynecol Obst Bio R · Jan 1983
Case Reports Randomized Controlled Trial Clinical Trial[Peridural analgesia during labor: comparative study of a fentanyl-marcaine combination and marcaine alone].
A randomised trial was carried out to evaluate the use of a mixture of fentanyl with marcaine in epidural analgesia. Two series of 30 patients each were studied: in the first only marcaine was given for the epidural and in the second marcaine and fentanyl mixed. Stronger and longer analgesia was obtained in the series where fentanyl was added showing that local anaesthetics can be potentiated by opiates. There was no significant difference in the two series as far as the cardiovascular, respiratory and blood gas measurements were concerned, either in the mother or in the fetus.