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Yuan J, Jin A, Shen J, Chen Y, Huang Q, Xiang H. Maternal intrapartum fever during epidural labour analgesia: Incidence and influencing factors. Int J Nurs Pract 2024; 30:e13188. [PMID: 37667558 DOI: 10.1111/ijn.13188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 07/14/2023] [Accepted: 07/28/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND The management and nursing care of women's temperature during delivery is an important part of clinical obstetrics. We aimed to evaluate maternal intrapartum fever during epidural labour analgesia to provide evidence for the management and care of women in labour. METHODS This study was conducted and reported according to the STROBE statement. Women in labour undergoing epidural labour analgesia in our hospital from 1 January 2021 to 31 August 2022 were retrospectively selected. The characteristics of women in labour with and without intrapartum fever were compared. Pearson correlation and logistic regression analysis were used to analyse the influencing factors of postpartum fever. RESULTS A total of 196 women in labour were included, the incidence of maternal intrapartum fever in women in labour undergoing epidural analgesia was 27.5%. Pearson correlation analyses showed that BMI, oxytocin use, labour duration, number of vaginal examinations, time from rupture of the foetal membranes to the end of labour and duration of epidural analgesia were all correlated with the occurrence of intrapartum fever (all P < 0.05). Logistic regression analyses indicated that body mass index ≥28 kg/m2 (OR = 1.825), oxytocin use (OR = 2.082), labour duration ≥9.2 h (OR = 2.613), number of vaginal examinations ≥8 (OR = 2.044-3.115), the time from rupture of the foetal membranes to the end of labour ≥250 min (OR = 2.766) and duration of epidural analgesia ≥300 min (OR = 3.106) were risk factors for intrapartum fever in women in labour undergoing epidural analgesia (all P < 0.05). CONCLUSIONS Maternal intrapartum fever in women in labour undergoing epidural analgesia is common and influenced by many factors. Nurses should take early preventive care measures according to these factors during epidural analgesia in labour.
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Affiliation(s)
- Jinhua Yuan
- Delivery room, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Aiying Jin
- Delivery room, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jie Shen
- Delivery room, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Youguo Chen
- Delivery room, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Qin Huang
- Delivery room, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Haiyan Xiang
- Delivery room, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Meng X, Ye J, Qiao P, Ren T, Luo Q, Hu LQ, Zhang J. Labor Neuraxial Analgesia and Its Association With Perinatal Outcomes in China in 2015-2016: A Propensity Score-Matched Analysis. Anesth Analg 2023; 137:1047-1055. [PMID: 37862597 DOI: 10.1213/ane.0000000000006435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND The use of labor neuraxial analgesia (NA) in China has increased significantly in the past decade, and the current rate of use is unknown. This study aimed to describe the epidemiology of NA based on a large multicenter cross-sectional survey, the China Labor and Delivery Survey (CLDS) (2015-2016), and to evaluate the association between NA and intrapartum caesarean delivery (CD) and maternal and neonatal outcomes. METHODS The CLDS was a facility-based cross-sectional investigation with a cluster random sampling scheme conducted from 2015 to 2016. A specific weight was assigned to each individual based on the sampling frame. Logistic regression was adopted to analyze the factors associated with the use of NA. A propensity score matching scheme was used to analyze the associations between NA and intrapartum CD and perinatal outcomes. RESULTS A total of 51,488 vaginal deliveries or intrapartum CD were included in our study, excluding prelabor CDs. The weighted NA rate was 17.3% (95% confidence interval [CI], 16.6-18.0) in this survey population. Nulliparous, previous CD, hypertensive disorders, and labor augmentation were associated with higher use of NA. In the propensity score-matched analysis, NA was associated with reduced risks of intrapartum CD, especially intrapartum CD by maternal request (adjusted odds ratio [aOR], 0.68; 95% CI, 0.60-0.78 and aOR, 0.48; 95% CI, 0.30-0.76, respectively), 3rd or 4th degree perineal laceration (aOR, 0.36; 95% CI, 0.15-0.89), and 5-minute Apgar score ≤3 (aOR, 0.15; 95% CI, 0.03-0.66). CONCLUSIONS The use of NA may be associated with improved obstetric outcomes, including fewer intrapartum CD, less birth canal trauma, and better neonatal outcomes in China.
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Affiliation(s)
- Xi Meng
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiangfeng Ye
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping Qiao
- Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tai Ren
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Luo
- Department of Research Service, Hainan Women and Children's Medical Center, Haikou, Hainan, China
| | - Ling-Qun Hu
- Department of Obstetric Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jun Zhang
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Research Service, Hainan Women and Children's Medical Center, Haikou, Hainan, China
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Zhang Z, Deng CM, Ma JH, Li S, Lei B, Ding T. Effects of neuraxial labor analgesia on intrapartum maternal fever in full-term pregnancy and its influence on birth outcomes. Front Med (Lausanne) 2023; 10:1208570. [PMID: 37534315 PMCID: PMC10390729 DOI: 10.3389/fmed.2023.1208570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/27/2023] [Indexed: 08/04/2023] Open
Abstract
Introduction This study aimed to explore the relationship between neuraxial labor analgesia and intrapartum fever and to demonstrate the influence of maternal fever on perinatal outcomes within 6 weeks after birth. Methods This was a secondary analysis of a multicenter prospective cohort study that enrolled women with single- and full-term cephalic pregnancy in northern China. Intrapartum maternal fever was defined as the highest axillary temperature during labor ≥37.5°C. Data on baseline characteristics, maternal variables, and neonatal outcomes were all collected. The association between neuraxial labor analgesia and intrapartum maternal fever was analyzed with logistic regression models, and the cutoff point was identified by the receiver operating characteristic curve. Results Of 577 parturients, 74 (12.8%) developed intrapartum fever. Neuraxial analgesia was associated with an increased risk of maternal intrapartum fever with or without adjusting for confounding factors (adjusted OR = 2.68; 95% CI: 1.32-5.47; p = 0.007). Further analysis showed that neuraxial analgesia of <5 h did not increase the risk of intrapartum fever compared with no analgesia (OR = 1.52; 95% CI: 0.63-3.64; p = 0.35), and longer neuraxial labor analgesia time (over 5 h) significantly increased the risk of fever (OR = 3.38; 95% CI: 1.63-7.01; p = 0.001). Parturients with intrapartum fever suffered more maternal adverse outcomes compared with those without fever (p < 0.001). Neonates of women with intrapartum fever had slightly higher rates of composite adverse neonatal outcomes compared with those without fever; however, the difference was not statistically significant (p = 0.098). Conclusion In women with low-risk pregnancies, a longer time of neuraxial labor analgesia was associated with an increased risk of intrapartum maternal fever. Intrapartum fever was related to adverse maternal outcomes but did not significantly affect neonatal outcomes within 6 weeks after delivery.
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Affiliation(s)
- Zhen Zhang
- Department of Anesthesiology, Peking University First Hospital, Beijing, China
| | - Chun-Mei Deng
- Department of Anesthesiology, Peking University First Hospital, Beijing, China
| | - Jia-Hui Ma
- Department of Anesthesiology, Peking University First Hospital, Beijing, China
| | - Shu Li
- Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Beijing, China
| | - Bo Lei
- Department of Anesthesiology, Haidian Maternal and Child Health Hospital, Beijing, China
| | - Ting Ding
- Department of Anesthesiology, Peking University First Hospital, Beijing, China
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Guesine GD, Paschoini MC, Melo GA, Araujo Júnior E, Peixoto AB. Labor analgesia and its impact on the maternal and perinatal outcomes. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230500. [PMID: 37466614 DOI: 10.1590/1806-9282.20230500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE This study aimed to assess adverse maternal and perinatal outcomes in parturients undergoing labor analgesia. METHODS This was a retrospective cohort study in parturients who underwent labor analgesia. Parturients were categorized into three groups: Group 1 (n=83)-analgesia performed with cervical dilatation ≤4.0 cm; Group 2 (n=82)-analgesia performed with cervical dilatation between 5.0 and 8.0 cm; and Group 3 (n=83)-analgesia performed with cervical dilatation ≥9.0 cm. RESULTS Analgesia in parturients with cervical dilatation ≥9.0 cm showed a higher prevalence and a 3.86-fold increase (OR 3.86; 95%CI 1.50-9.87; p=0.009) in the risk of forceps delivery. Analgesia in parturients with cervical dilatation ≤4.0 cm showed a higher prevalence and a 3.31-fold increase (OR 3.31; 95%CI 1.62-6.77; p=0.0016) in the risk of cesarean section. Analgesia in parturients with cervical dilatation ≥9.0 cm was associated with a higher prevalence of fetal bradycardia (20.7%), a need for neonatal oxygen therapy (6.1%), and a need for admission to a neonatal intensive care unit (4.9%). Analgesia in parturients with cervical dilatation ≤4 cm was associated with a higher prevalence of Apgar score <7 at 1st minute (44.6%). CONCLUSION Performing labor analgesia in parturients with cervical dilatation ≤4.0 or ≥9.0 cm was associated with a higher prevalence of adverse maternal and perinatal outcomes.
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Affiliation(s)
- Georgeana Debs Guesine
- Universidade de Uberaba, Mário Palmério University Hospital, Gynecology and Obstetrics Service - Uberaba (MG), Brazil
| | - Marina Carvalho Paschoini
- Universidade Federal do Triângulo Mineiro, Department of Obstetrics and Gynecology - Uberaba (MG), Brazil
| | - Giselle Agreli Melo
- Universidade de Uberaba, Mário Palmério University Hospital, Gynecology and Obstetrics Service - Uberaba (MG), Brazil
| | - Edward Araujo Júnior
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Obstetrics - São Paulo (SP), Brazil
- Universidade Municipal de São Caetano do Sul, Medical Course - São Paulo (SP), Brazil
| | - Alberto Borges Peixoto
- Universidade de Uberaba, Mário Palmério University Hospital, Gynecology and Obstetrics Service - Uberaba (MG), Brazil
- Universidade Federal do Triângulo Mineiro, Department of Obstetrics and Gynecology - Uberaba (MG), Brazil
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Lazzari C, Raffaelli R, D'Alessandro R, Simonetto C, Bosco M, Zorzato PC, Uccella S, Taddei F, Franchi M, Garzon S. Effects of neuraxial analgesia technique on labor and maternal-fetal outcomes: a retrospective study. Arch Gynecol Obstet 2023; 307:1233-1241. [PMID: 35599249 PMCID: PMC10023596 DOI: 10.1007/s00404-022-06600-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/27/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the effects of epidural analgesia (EA) and combined spinal epidural analgesia (SEA) on labor and maternal-fetal outcomes. METHODS We retrospectively identified and included 1499 patients with a single cephalic fetus who delivered at the study center from January 2015 to December 2018 and received neuraxial analgesia at the beginning of the active phase of labor (presence of regular painful contractions and cervical dilatation between 4 and 6 cm). Data including analgesia, labor characteristics, and maternal-fetal outcomes were retrieved from the prospectively collected delivery room database and medical records. RESULTS SEA was associated with a shorter first stage of labor than EA, with a median difference of 60 min. On multivariable ordinal logistic regression analysis, neuraxial analgesia, gestational age, fetal weight, labor induction, and parity were independently associated with the first stage length: patients in the EA group were 1.32 times more likely to have a longer first stage of labor (95% CI 1.06-1.64, p = 0.012) than those in the SEA group. Additionally, a significantly lower incidence of fundal pressure was performed among patients who underwent SEA (OR 0.55, 95% CI 0.34-0.9, p = 0.017). No associations were observed between the used neuraxial analgesia technique and other outcomes. CONCLUSIONS SEA was associated with a shorter length of the first stage of labor and a lower rate of fundal pressure use than EA. Further studies confirming the effects of SEA on labor management and clarifying differences in maternal-fetal outcomes will allow concluding about the superiority of one technique upon the other.
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Affiliation(s)
- Cecilia Lazzari
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
- Department of Obstetrics and Gynecology, Santa Chiara Hospital, APSS Trento, Trento, Italy
| | - Ricciarda Raffaelli
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Roberto D'Alessandro
- Department of Anesthesia and Intensive Care, AOUI Verona, University of Verona, Verona, Italy
| | - Chiara Simonetto
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Mariachiara Bosco
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy.
| | - Pier Carlo Zorzato
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Fabrizio Taddei
- Department of Obstetrics and Gynecology, Santa Chiara Hospital, APSS Trento, Trento, Italy
| | - Massimo Franchi
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
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Interventions for the prevention or treatment of epidural-related maternal fever: a systematic review and meta-analysis. Br J Anaesth 2022; 129:567-580. [PMID: 35934529 PMCID: PMC9575042 DOI: 10.1016/j.bja.2022.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 05/18/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022] Open
Abstract
Background Epidural-related maternal fever in women in labour has consequences for the mother and neonate. There has been no systematic review of preventive strategies. Methods RCTs evaluating methods of preventing or treating epidural-related maternal fever in women in active labour were eligible. We searched MEDLINE, EMBASE, CINAHL, Web of Science, CENTRAL, and grey literature sources were searched from inception to April 2021. Two review authors independently undertook study selection. Data extraction and quality assessment was performed by a single author and checked by a second. The Cochrane Risk of Bias 2 tool was used. Meta-analyses for the primary outcome, incidence of intrapartum fever, were performed using the DerSimonian and Laird random effects model to produce summary risk ratios (RRs) with 95% confidence intervals (95% CIs). Results Forty-two records, representing 34 studies, were included. Methods of reduced dose epidural reduced the incidence of intrapartum fever, but this was not statistically significant when six trials at high risk of bias were removed (seven trials; 857 participants; RR=0.83; 95% CI, 0.41–1.67). Alternative methods of analgesia and high-dose prophylactic systemic steroids reduced the risk of intrapartum fever compared with epidural analgesia. Prophylactic paracetamol was not effective. Conclusions There is no clear evidence to support the use of any individual preventative or therapeutic intervention for epidural-related maternal fever. Further research should focus on understanding the mechanism of fever development to enable RCTs of potential interventions to reduce the incidence of intrapartum fever development and the subsequent disease burden felt by the neonate. Clinical trial registration CRD42021246929.
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Zuo R, Dang J, Zhuang J, Chen Q, Zhang J, Zheng H, Wang Z. The incidence of breakthrough pain of different programmed intermittent bolus volumes for labor epidural analgesia: a randomized controlled trial. Int J Obstet Anesth 2022; 51:103571. [DOI: 10.1016/j.ijoa.2022.103571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 04/27/2022] [Accepted: 06/19/2022] [Indexed: 11/27/2022]
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Cherel Q, Burey J, Rousset J, Picard A, Mirza D, Dias C, Jacquet H, Mariani P, Raffegeau N, Saupin I, Bornes M, Lapidus N, Quesnel C, Garnier M. Epidural analgesia information sessions provided by anesthetic nurses: impact on satisfaction and anxiety of parturient women a prospective sequential study. BMC Anesthesiol 2022; 22:105. [PMID: 35413841 PMCID: PMC9002221 DOI: 10.1186/s12871-022-01647-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Information on epidural analgesia delivered to parturient women is frequently incomplete, making it difficult for expectant mothers to make an appropriate choice for their delivery. We assessed the impact of a multimodal information session on epidural analgesia delegated to anesthetic nurses on new-mothers' satisfaction. METHODS We performed a prospective sequential study including parturient women who gave birth with epidural analgesia. During the first period, information on epidural analgesia was delivered by anesthetists during the scheduled anesthesia consultation, according to French standard-of-care. Then, a dedicated information session about epidural analgesia provided by anesthetic nurses was implemented. The primary endpoint was the satisfaction of women with the quality of information received. Main secondary endpoints were knowledge of women about epidural analgesia, anxiety before epidural catheter placement, and satisfaction with delivery. RESULTS 259 and 298 women were included during the first and second periods respectively, among whom 178 and 188 were analyzed. Information on epidural analgesia delivered by anesthetic nurses was associated with improvement of new-mothers' satisfaction with information received (9 (8-10) vs. 10 (9-10) - p < 0.001). Moreover, information delivered by anesthetic nurses was associated with decreased anxiety before epidural catheter placement (4 (1-8) vs. 3 (1-6) - p = 0.006) and increased satisfaction with delivery (8 (7-10) vs. 9 (8-10) - p = 0.01). Women's knowledge on epidural analgesia was durably increased when information was delivered by anesthetic nurses compared to conventional information by anesthetists. After adjustment, the only variable associated with both new mothers' satisfaction with information and delivery was the information session taught by anesthetic nurses. CONCLUSIONS Information sessions on epidural analgesia delivered by anesthetic nurses was associated with improved satisfaction of women with their delivery. Such information sessions may be used in maternity wards to improve new-mothers' childbirth experience.
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Affiliation(s)
- Quentin Cherel
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Julien Burey
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Julien Rousset
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Anne Picard
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Dimitra Mirza
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Christina Dias
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Hélène Jacquet
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Paule Mariani
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Nathalie Raffegeau
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Isabelle Saupin
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Marie Bornes
- Service de gynécologie-obstétrique, Hôpital Tenon, Sorbonne Université, APHP, DMU ORIGYNE, 4 rue de la Chine, 75020, Paris, France
| | - Nathanaël Lapidus
- Département de Santé Publique, Hôpital Saint-Antoine, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, APHP, Sorbonne Université, 184 rue du Faubourg St Antoine, 75012, Paris, France
| | - Christophe Quesnel
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France
| | - Marc Garnier
- Service d'anesthésie, réanimation et médecine périopératoire, Hôpital Tenon, Sorbonne Université, GRC29, APHP, DMU DREAM, 4 rue de la Chine, 75020, Paris, France.
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Triunfo S, Bellaminutti S, Papadia A. Performing in-depth analysis of pain control strategies based on low concentration of local anesthetic during labor. Arch Gynecol Obstet 2020; 304:279-280. [PMID: 32734412 DOI: 10.1007/s00404-020-05720-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 07/27/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Stefania Triunfo
- Department of Obstetrics and Gynecology, Ente Ospedaliere Cantonale, University of the Italian Switzerland, Via Tesserete 46, 6900, Lugano, Switzerland.
| | - Serena Bellaminutti
- Department of Obstetrics and Gynecology, Ente Ospedaliere Cantonale, University of the Italian Switzerland, Via Tesserete 46, 6900, Lugano, Switzerland
| | - Andrea Papadia
- Department of Obstetrics and Gynecology, Ente Ospedaliere Cantonale, University of the Italian Switzerland, Via Tesserete 46, 6900, Lugano, Switzerland
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