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ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.
Eur J Anaesthesiol
February 2025
From the Servicio de Anestesia y Reanimación, Hospital Universitario Gregorio Marañón, Calle de O'Donnell, 48, 28009 Madrid, Madrid, Spain (NB), the Servicio de Anestesia, Hospital Universitario Sanitas La Zarzuela, Madrid, c/ Pleyades, 25, 28023 Madrid, Spain (NB), the Servicio de Anestesia y Reanimación, Hospital Universitario La Paz, Madrid, P° de la Castellana, 261, 28046 Madrid, Spain (IVG), the Department of Paediatric and Obstetric Anaesthesiology, Juliane Marie Centre, Rigshospitalet & Institute of Clinical Medicine, University Hospital of Copenhagen, Copenhagen, Denmark (AA, KL), the University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany (PK, SR), the Division of Anesthesia Critical Care and Pain, Tel Aviv Sourasky Medical Center affiliated with the Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv Israel (CFW), the London North West NHS University Trust, Watford Road, London, UK HA1 3UJ (NL), the Department of Anesthesia & Intensive Care Medicine, Liège University Hospital, Belgium (PYD), the Servicio de Anestesia y Reanimación. Hospital Universitario Fundación Jiménez Díaz. Av. de los Reyes Católicos, 2. 28040 Madrid. Spain (EGA), the Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, Hebrew University, Shmuel Beyth St 12, Jerusalem, 9103102 Israel (AI), the Department of Anesthesia and Intensive Care, Akademiska Sjukhuset, Sjukhusvägen, 75185, Uppsala, Sweden (AK), the Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel affiliated with Tel Aviv University Medical School (SOZ), the Department of Anaesthesiology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands (OvdB), the Department of Cardiovascular Sciences, KU Leuven, and Department of Anaesthesiology, UZ Leuven, Belgium (MvdV), the Department of Anaesthesia, Intensive Care and Pain Medicine, University General Hospital of Valencia, Methodology Department, European University of Valencia, Valencia, Spain (CSR).
Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.
Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.
How and why does mode of birth affect processes for routine data collection and use? A qualitative study in Bangladesh and Tanzania.
PLOS Glob Public Health
December 2024
Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
The World Health Organization recognises Routine Health Information System (RHIS) data as integral to data-driven health systems; needed to improve intrapartum outcomes for maternal and newborn health worldwide. However, research in Bangladesh and Tanzania suggests that mode of birth affects register data accuracy, but little is known about why. To address this gap, we undertook qualitative research in these two public-sector health systems.
View Article and Find Full Text PDFUtilizing machine learning to predict the risk factors of episiotomy in parturient women.
AJOG Glob Rep
February 2025
Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran (all authors).
Background: Episiotomy has specific indications that, if properly followed, can effectively prevent women from experiencing severe lacerations that may result in significant complications like anal incontinence. However, the risk factors related to episiotomy has been the center of much debate in the medical field in the past few years.
Objective: The present study used a machine learning model to predict the factors that put women at the risk of having episiotomy using intrapartum data.
Psychometric evaluation and adaptation of the COMICE questionnaire for Swedish midwifery students.
Eur J Midwifery
December 2024
Department of Health Science, Mid Sweden University, Sundsvall, Sweden.
Introduction: The world needs skilled, well educated, and confident midwives, but there is a lack of instruments to measure confidence in the Swedish context. The aim was to psychometrically test and adapt the COMICE (Confidence Of Midwifery students on selected midwifery Competencies at completion of Education) questionnaire on Swedish midwifery students.
Methods: This is a national cross-sectional study of midwifery students from all 13 universities in Sweden in 2016-2017.
Rational approach to fetal heart rate monitoring and management during the second stage of labor.
Eur J Obstet Gynecol Reprod Biol
December 2024
Direttore UOC Ostetricia e Ginecologia, Azienda Ospedaliera Universitaria di Parma, Professore Ordinario di Ginecologia e Ostetricia, Direttore della Scuola di Specializzazione in Ostetricia e Ginecologia, Presidente del CdS OstetriciaUniversità di Parma, Italy. Electronic address:
Second stage of labor is considered to be associated with an increased risk of intrapartum fetal hypoxic injury. This is due to a combination of several risk factors such as -the increased frequency, strength and duration of uterine contractions due to higher number and affinity of myometrial oxytocin receptors; -the Ferguson's reflex which leads to a reflex release of endogenous oxytocin in response of the distension of the cervix by descending fetal head in late stages of labor; maternal expulsive efforts with the Valsalva manoeuvre that may reduce maternal oxygenation, as well as reduce the venous return and maternal cardiac output due to increased intrathoracic pressure, winch may lead to reduced placental oxygenation; - and increased fetal intracranial pressure due to head compression leading to a potential decrease in fetal cerebral oxygenation. In addition, the umbilical cord often forms one or more loops around the fetal neck, which may get tightened as the head descends leading to an acute and intermittent cessation of fetal oxygenation.
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