Epidural: are mom and baby at risk?

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Philippe Gloaguen
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Safe epidural for mothers and babies

This is the doubt of many mothers, tempted by an epidural to reduce the pain of labor and delivery: but will it be safe, for themselves and for the baby? Science says yes. “Numerous data are available in the medical literature that show the safety of epidural anesthesia, both for the mother and for the child,” says Luigi Fedele, former head of the obstetrics and gynecology department of the Clinic in our city.





"Obviously, these procedures must be performed by a qualified anesthetist who manages the case in collaboration with the obstetrician and the gynecologist, who will check the fetal well-being with continuous or periodic cardiotocographic monitoring".

Read also: Giving birth painlessly with an epidural

Possible side effects for mom


Of course, some side effects are always possible. The most frequent (but basically harmless) are a lowering of blood pressure of the mother (hypotension) and the appearance of fever during childbirth or in the following hours (but often the mother does not even notice).



Also they can occur headache - annoying but temporary, and in any case treatable with common analgesics, not to mention that there are nine therapeutic possibilities on the horizon, based for example on the combination of drugs such as prostigmine and atropine - low back pain (i.e. backache, which, however, often depends more on the effort of childbirth itself than on analgesia), itching and tingling in the lower limbs, metallic taste in the mouth, some cases of water retention.

"I am definitely rare or very rare, of the order of one case every 10 or 20 thousand analgesia, more serious consequences, like one allergic reaction to the anesthetic or neurological damage as peridural hematomas "points out Fedele.

Consequences with respect to childbirth

"The available data say that with the epidural there may be a little one lengthening of the expulsive phase of childbirth (in the order of 20 minutes) and an aincreased risk of operative deliveryor (use of the suction cup, or oxytocin to stimulate contractions) ", underlines Carlo Buffi, former head of obstetrics and gynecology at the Valdelsa Hospital in Poggibonsi (SI), now a freelance gynecologist.



However, the most recent data seem to indicate that this effect on the risk of operative childbirth has been decreasing over time, probably due to a improvement of techniques and a recourse to increasingly reduced dosages of anesthetic drugs. On the other hand, there are no consequences with respect to the risk of caesarean section.

No significant consequences for the child


And what about the baby? The studies speak for themselves: “Half an hour after the first administration of analgesia, one can occur reduction in heart rate"Buffi points out." However, it is now clear that this is not a sign of fetal distress. In fact, five minutes after birth, the Apgar index, an index that measures the state of health of the newborn baby, is the same in the births with and without an epidural ". And the same goes for the risk of admission to intensive neonatal therapy, as a recent review of scientific studies on the subject shows.

Read also: Epidural, critical opinion

Sources for this article: consultancy from Carlo Buffi, former head of obstetrics and gynecology at the Valdelsa Hospital in Poggibonsi (SI); advice from prof. Luigi Fedele, former head of the obstetrics and gynecology department of the Clinic in our city; information booklet "Pain from childbirth: knowing and controlling it" produced by the Polyclinic of our city; video produced by the Polyclinic of our city; Cochrane Epidurals review for pain relief in labor

 

Updated on 17.01.2022

TAG:
  • epidural
  • give birth
  • labor
  • contractions
  • maternal hypotension
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