EPIDURAL ANALGESIA AND LABORS IN WOMEN WITH A UTERINE SCAR: WHAT IS THE DEGREE OF RISK?

Abstract

The article presents the results of a prospective controlled longitudinal study involving 69 reproductive women with a uterine scar after a cesarean section in previous labor. In women included in the study births were performed vaginally. Patients were divided into two groups: the first group consisted of 38 women with a uterine scar, whose vaginal deliveries were anesthetized by the method of epidural analgesia; the second group included 31 multipara patients with a uterine scar, in which the births were carried vaginally without epidural analgesia. Over the course of a study epidural analgesia was shown to be effective method of anesthetizing labor in women with a uterine scar. Epidural analgesia in vaginal delivery in women with a uterine scar is concluded do not influence on the risk of untimely diagnosis of the beginning uterine rupture. Diagnostic criteria for the beginning uterine rupture on the background of epidural analgesia should be considered for any of following criteria: the emergence of a severe pain syndrome, not associated with the contractile activity of the uterus; signs of the sudden deterioration of the state of the fetus; change in the fetal heart rate; change in the tone of the uterus and the nature of its contractions; termination of labor activity; a sudden change in one or more vital signs of the parturient (BPmean, HR, RR).

Keywords

childbirth / epidural analgesia / uterine scar

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