RE: [ozmidwifery] epidural research

[Michelle Windsor]

Dean and Jo wrote: 

I seriously question the validity of the research being done these days!

I know what you mean Jo, and I seriously question some of the interpretation of research.  Some of the medical profession take any study that suits them and quote it as evidence based practice.  Today I went to an inservice on CTG's and outcomes from a study done in Dublin were quoted -  apparently the largest ever study on outcomes of CTG monitoring versus intermittent, involving over ten thousand women.  I haven't heard of this study (has anyone else?) but it supported the use of continuous monitoring and supposedly didn't increase their caesar rate.  I find it hard to believe especially when they went on to talk about the 50%-70% false positives for fetal distress with CTG's. 

Michelle

 

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Kylie Carberry
Sent: Thursday, February 17, 2005 10:13 AM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] epidural research

 

Hi everyone,

Just thought you all may be interested in a press release I found on the net and wanted to see what everyone thought.  I just gave my first-time pregnant sister-in-law a run down the risks of epidurals as she was very quick to say she will request one (of course her OB encouraged her, saying if I was a woman I'd have one....needless to say this made me cringe), what can I tell her about this new research.

 

Early epidural does not raise c-section risk

Last Updated: 2005-02-16 17:00:33 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Women in labor who need early pain relief need not fear that an epidural makes it more likely that they'll have to have a cesarean.

Compared with intravenous narcotic pain control, new research shows, epidural pain control started in early labor does not increase the probability that women will undergo a c-section.

Moreover, an early epidural seems to provide better pain control and may shorten the duration of labor.

Previous reports have linked epidural analgesia with an elevated risk of cesarean delivery, but it is possible that this increased risk was due to related factors and not to the epidural per se, the researchers note in this week's New England Journal of Medicine.

To determine if epidural pain control is an inherent risk factor for c-section, Dr. Cynthia A. Wong, from Northwestern University in Chicago, and colleagues assessed the outcomes of 750 pregnant women who received epidural pain control or intravenous hydromorphone started in the early stages of labor.

In contrast to previous reports, the c-section rate in the epidural group was actually slightly lower than that seen in the comparison group: 17.8 versus 20.7 percent.

There was evidence that epidural pain control hastened delivery. The time from the start of pain control until delivery was significantly shorter in the epidural group.

In addition, epidural anesthesia was associated with significant improvements in pain and with better Apgar scores, the system used to evaluate infants in the first minutes of life.

In a related editorial, Dr. William Camann, from Brigham and Women's Hospital in Boston, comments that for women who experience severe pain in early labor and desire pain control, the new findings "make it clear that safe, effective pain relief with the use of (epidural pain control) should not be withheld simply because" they haven't passed some arbitrary stage.

SOURCE: New England Journal of Medicine, February 17, 2005.

Copyright © 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

 

 

Kylie Carberry

Freelance Journalist

p: 02 42970115

m: 0418 220 638

f: 02 42970747

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