2021, Number 2
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Revista Cubana de Obstetricia y Ginecología 2021; 47 (2)
Effects of using epidural anesthesia during childbirth on the pelvic floor
Núñez RL, Da Cuña CI, Alonso CA, González GY
Language: Spanish
References: 34
Page: 1-11
PDF size: 463.45 Kb.
ABSTRACT
Introduction: There are numerous pharmacological and non-pharmacological methods dedicated to reducing the pain experienced during childbirth, and to controlling and reducing, the physical and emotional consequences derived from it.
Objective: To analyze the possible consequences derived from the use of epidural anesthesia during childbirth and in the pelvic floor.
Methods: A bibliographic search was carried out to review the scientific literature on the subject in the PubMed, Medline and Cinhal databases, in March 2020.
Analysis and synthesis of the information: The inclusion criteria were articles in Spanish and English, and the exclusion criteria those works that did not fit the objective or the type of study. After applying the eligibility criteria, 13 articles were chosen to review. All analyzed variables related to the pelvic floor, such as urinary incontinence, prolapse, or chronic pelvic pain, after the application of epidural analgesia during childbirth.
Conclusions: Epidural analgesia is an effective method to reduce pain during labor, however, it is not possible to show that it has consequences on the pelvic floor or childbirth compared to women who give birth without analgesia.
REFERENCES
Anim-Somuah M, Smyth RMD, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018(5).
Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018;5:CD000331.
Sng BL, Sia ATH. Maintenance of epidural labour analgesia: The old, the new and the future. Best Pract Res Clin Anaesthesiol. 2017;31(1):15-22.
Wang Q, Zheng S-X, Ni Y-F, Lu Y-Y, Zhang B, Lian Q-Q, et al. The effect of labor epidural analgesia on maternal-fetal outcomes: a retrospective cohort study. Arch Gynecol Obstet. 2018;298(1):89-96.
Wang Q, Zheng SX, Ni YF, Lu YY, Zhang B, Lian QQ, et al. The effect of labor epidural analgesia on maternal–fetal outcomes: a retrospective cohort study. Arch Gynecol Obstet. 2018;298(1):89–96.
Urbankova I, Grohregin K, Hanacek J, Krcmar M, Feyereisl J, Deprest J, et al. The effect of the first vaginal birth on pelvic floor anatomy and dysfunction. Int Urogynecol J. 2019 Oct 1;30(10):1689–96.
Xing JJ, Liu XF, Xiong XM, Huang L, Lao CY, Yang M, et al. Effects of combined spinal-epidural analgesia during labor on postpartum electrophysiological function of maternal pelvic floor muscle: A randomized controlled trial. PLoS One. 2015;10(9):1–10.
Meyer S, Achtari C, Hohlfeld P, De Grandi P, Buchser E. Effects of epidural analgesia on pelvic floor function after spontaneous delivery: A longitudinal retrospective study. Int Urogynecol J. 2002;13(6):359–65.
Hatamleh R, Ali RA, Elian AI. Epidural analgesia and its effects on maternal and neonatal outcomes: a retrospective comparable study in Northern Jordan. Evidence-based midwifery. 2019;17(4):135–42.
Felisbino-Mendes M, Santos L, Amorim T, Costa IN, Martins F. Does the use of pharmacological analgesia influence childbirth outcomes? Acta Paulista Enfermagem. 2017;30(5):458–65. DOI: http://dx.doi.org/10.1590/1982
Serati M, Salvatore S, Khullar V, Uccella S, Bertelli E, Ghezzi F, et al. Prospective study to assess risk factors for pelvic floor dysfunction after delivery. Acta Obstet Gynecol Scand. 2008;87(3):313–8.
Sartore A, Pregazzi R, Bortoli P, Grimaldi E, Ricci G, Guaschino S. Effects of epidural analgesia during labor on pelvic floor function after vaginal delivery. Acta Obstet Gynecol Scand. 2003;82(2):143–6.
Teo R, Punter J, Abrams K, Mayne C, Tincello D. Clinically overt postpartum urinary retention after vaginal delivery: A retrospective case-control study. Int Urogynecol J. 2007;18(5):521–4.
Wang Q, Yu X, Sun X, Wang J. Does epidural anesthesia influence pelvic floor muscle endurance and strength and the prevalence of urinary incontinence 6 weeks postpartum? Int Urogynecol J. 2020 Mar;31(3):577-82.
Nguyen USDT, Rothman KJ, Demissie S, Jackson DJ, Lang JM, Ecker JL. Epidural analgesia and risks of cesarean and operative vaginal deliveries in nulliparous and multiparous women. Matern Child Health J. 2010 Sep;14(5):705–12.
Garcia-Lausin L, Perez-Botella M, Duran X, Rodríguez-Pradera S, Gutierrez-Martí MJ, Escuriet R. Relation between Epidural Analgesia and severe perineal laceration in childbearing women in Catalonia. Midwifery. 2019 Mar 1;70:76–83.
Cappell J, Pukall CF. Clinical profile of persistent genito-pelvic postpartum pain. Midwifery. 2017 Jul 1;50:125–32.
Cheng YW, Caughey AB. Second Stage of Labor. Clin Obstet Gynecol. 2015;58(2):227–40.
Rouse DJ, Weiner SJ, Bloom SL, Varner MW, Spong CY, Ramin SM, et al. Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes. Am J Obstet Gynecol. 2009;201(4):357.e1-357.e7. DOI: http://dx.doi.org/10.1016/j.ajog.2009.08.003
Page K, McCool WF, Guidera M. Examination of the Pharmacology of Oxytocin and Clinical Guidelines for Use in Labor. J Midwifery Women’s Heal. 2017;62(4):425–33.
Wiklund I, Norman M, Uvnäs-Moberg K, Ransjö-Arvidson AB, Andolf E. Epidural analgesia: Breast-feeding success and related factors. Midwifery. 2009;
Gabriel MAM, Fernández IO, Martínez AMM, Armengod CG, Costarelli V, Santos IM, et al. Intrapartum synthetic oxytocin reduce the expression of primitive reflexes associated with breastfeeding. Breastfeed Med. 2015;10(4):209–13.
Blomquist JL, McDermott K, Handa VL. Pelvic pain and mode of delivery. Am J Obstet Gynecol. 2014;210(5):423.e1-423.e6.
Paterson LQP, Davis SNP, Khalifé S, Amsel R, Binik YM. Persistent genital and pelvic pain after childbirth. J Sex Med. 2009;6(1):215–21.
Turmo M, Echevarria M, Rubio P, Almeida C. Cronificación del dolor tras episiotomía. Rev Esp Anestesiol Reanim. 2015;62(8):436–42. DOI: http://dx.doi.org/10.1016/j.redar.2014.10.008
McDonald EA, Gartland D, Small R, Brown SJ. Dyspareunia and childbirth: A prospective cohort study. BJOG an Int J Obstet Gynaecol. 2015;122(5):672–9.
Kountanis J, Vahabzadeh C, Bauer S, Muzik M, Cassidy R, Aman C, et al. Labor epidural analgesia and the risk of postpartum depression: A meta-analysis of observational studies. J Clin Anesth. 2020;61(June):109658. DOI: https://doi.org/10.1016/j.jclinane.2019.109658
Meky HK, Shaaban MM, Ahmed MR, Mohammed TY. Prevalence of postpartum depression regarding mode of delivery: a cross-sectional study. J Matern Neonatal Med. 2019;0(0):1–8. DOI: https://doi.org/10.1080/14767058.2019.1571572
Prado DS, Mendes RB, Gurgel RQ, Barreto ID de C, Cipolotti R, Gurgel RQ. The influence of mode of delivery on neonatal and maternal short and longterm outcomes. Rev Saude Publica. 2018;52:1–11.
Simmons S, Cyna AM, Dennis AT, Hughes D. Combined spinal-epidural versus epidural analgesia in labour. Cochrane Database Syst Rev. 2007;(3).
Dostbil A, Celik M, Alici HA, Erdem AF, Aksoy M, Ahiskalioglu A. Maternal and neonatal effects of adding morphine to low-dose bupivacaine for epidural labor analgesia. Niger J Clin Pract. 2014 Mar;17(2):205–11.
Ortiz-Gómez JR, Palacio-Abizanda FJ, Fornet-Ruiz I. Técnicas analgésicas para el parto: alternativas en caso de fallo de la epidural. An Sist Sanit Navar. 2014;37(3):411–27.
Koyyalamudi V, Sidhu G, Cornett EM, Nguyen V, Labrie-Brown C, Fox CJ, et al. New Labor Pain Treatment Options. Curr Pain Headache Rep. 2016;20(2):1–9.
Hellams A, Sprague T, Saldanha C, Archambault M. Nitrous oxide for labor analgesia. J Am Acad Physician Assist. 2018;31(1):41–4.