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https://doi.org/10.21256/zhaw-4281| Publication type: | Article in scientific journal |
| Type of review: | Peer review (publication) |
| Title: | The dynamics of epidural and opioid analgesia during labour |
| Authors: | Zondag, Dirkje C. Gross, Mechthild Maria Grylka-Baeschlin, Susanne Poat, Angela Petersen, Antje |
| DOI: | 10.21256/zhaw-4281 10.1007/s00404-016-4110-1 |
| Published in: | Archives of Gynecology and Obstetrics |
| Volume(Issue): | 294 |
| Issue: | 5 |
| Page(s): | 967 |
| Pages to: | 977 |
| Issue Date: | 2016 |
| Publisher / Ed. Institution: | Springer |
| ISSN: | 0932-0067 1432-0711 |
| Language: | English |
| Subjects: | Combined analgesia; Cox regression; Labour duration; Longitudinal studies; Spontaneous birth; Timing of interventions; Pregnancy |
| Subject (DDC): | 618.4: Childbirth |
| Abstract: | Purpose: To investigate the association of analgesia, opioids or epidural, or the combination of both with labour duration and spontaneous birth in nulliparous women. Methods: A secondary data analysis of an existing cohort study was performed and included nulliparous women (n = 2074). Durations of total labour and first and second labour stage were calculated with Kaplan-Meier estimation for the four different study groups: no analgesia (n = 620), opioid analgesia (n = 743), epidural analgesia (n = 482), and combined application (n = 229). Labour duration was compared by Cox regression while adjusting for confounders and censoring for operative births. Logistic regression was used to investigate the association between the administration of different types of analgesia and mode of birth. Results: Most women in the combined application group were first to receive opioid analgesia. Women with no analgesia had the shortest duration of labour (log rank p < 0.001) and highest chance of a spontaneous birth (p < 0.001). If analgesia was administered, women with opioids had a shorter first stage (p = 0.018), compared to women with epidural (p < 0.001) or women with combined application (p < 0.001). Women with opioids had an increased chance to reach full cervical dilatation (p = 0.006). Women with epidural analgesia (p < 0.001) and women with combined application (p < 0.001) had a prolonged second stage and decreased chance of spontaneous birth compared to women without analgesia. Conclusions: Women with opioids had a prolonged first stage, but increased chance to reach full cervical dilatation. Women with epidural analgesia and women with both opioid and epidural analgesia had a prolonged first and second stage and a decreased chance of a spontaneous birth. |
| Further description: | Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch) |
| URI: | https://digitalcollection.zhaw.ch/handle/11475/8159 |
| Fulltext version: | Published version |
| License (according to publishing contract): | Licence according to publishing contract |
| Restricted until: | 2021-12-01 |
| Departement: | School of Health Sciences |
| Organisational Unit: | Institute of Midwifery and Reproductive Health (IHG) |
| Appears in collections: | Publikationen Gesundheit |
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| File | Description | Size | Format | |
|---|---|---|---|---|
| 2016_Gross_TheDynamicsOfEpiduralAndOpioid.pdf | 484.16 kB | Adobe PDF |  View/Open |
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Zondag, D. C., Gross, M. M., Grylka-Baeschlin, S., Poat, A., & Petersen, A. (2016). The dynamics of epidural and opioid analgesia during labour. Archives of Gynecology and Obstetrics, 294(5), 967–977. https://doi.org/10.21256/zhaw-4281
Zondag, D.C. et al. (2016) ‘The dynamics of epidural and opioid analgesia during labour’, Archives of Gynecology and Obstetrics, 294(5), pp. 967–977. Available at: https://doi.org/10.21256/zhaw-4281.
D. C. Zondag, M. M. Gross, S. Grylka-Baeschlin, A. Poat, and A. Petersen, “The dynamics of epidural and opioid analgesia during labour,” Archives of Gynecology and Obstetrics, vol. 294, no. 5, pp. 967–977, 2016, doi: 10.21256/zhaw-4281.
ZONDAG, Dirkje C., Mechthild Maria GROSS, Susanne GRYLKA-BAESCHLIN, Angela POAT und Antje PETERSEN, 2016. The dynamics of epidural and opioid analgesia during labour. Archives of Gynecology and Obstetrics. 2016. Bd. 294, Nr. 5, S. 967–977. DOI 10.21256/zhaw-4281
Zondag, Dirkje C., Mechthild Maria Gross, Susanne Grylka-Baeschlin, Angela Poat, and Antje Petersen. 2016. “The Dynamics of Epidural and Opioid Analgesia during Labour.” Archives of Gynecology and Obstetrics 294 (5): 967–77. https://doi.org/10.21256/zhaw-4281.
Zondag, Dirkje C., et al. “The Dynamics of Epidural and Opioid Analgesia during Labour.” Archives of Gynecology and Obstetrics, vol. 294, no. 5, 2016, pp. 967–77, https://doi.org/10.21256/zhaw-4281.
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