British journal of obstetrics and gynaecology
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The effect of epidural analgesia on oxytocin release during the second stage of normal labour was studied by comparing 10 primigravidae who had epidurals with 10 control subjects who did not have epidurals. A significant increment in oxytocin between paired peripheral blood samples taken at the onset of full cervical dilatation and crowning of the fetal head was found in the control subjects but not in those with epidurals. Forceps delivery was required more often in the group with epidural analgesia and was associated with lower oxytocin levels at crowning. Since distension of the lower birth canal and stimulation of pelvic autonomic nerves leads to oxytocin release, and the need for forceps associated with epidurals can be reduced by oxytocin, these differences are attributed to the lumbar epidural block.
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Br J Obstet Gynaecol · Nov 1981
Letter Comparative StudyComparison of epidural and intramuscular pethidine for analgesia in labour.
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Br J Obstet Gynaecol · Jul 1981
Comparative StudyComparison of epidural and intramuscular pethidine for analgesia in labour.
Analgesia mediated by a direct spinal action of narcotic drugs administered via the epidural route may have considerable advantages over conventional(conduction block) epidural analgesia in labour. The efficacy, mode of action and placental transfer of epidurally administered narcotics in labour has not yet been established. ⋯ The superior analgesia following epidural pethidine did not appear to be attributable to a selective spinal action but rather to higher plasma concentrations of pethidine together with a possible weak regional conduction block due to local anaesthetic action of 1% pethidine solution. Epidural pethidine is not an advantageous method for providing analgesia in labour.
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Br J Obstet Gynaecol · Jun 1981
Case ReportsFetal heart monitoring during open heart surgery. Two case reports.
Two patients with critical mitral stenosis underwent open mitral valvotomy during the third trimester of pregnancy. Fetal monitoring throughout heart-lung bypass produced evidence of acute fetal hypoxia. Healthy live full-term infants were subsequently delivered.