The Committee forward Practice Bull...

The Committee forward Practice Bulletins of the American association of Obstetricians and Gynecologists (ACOG) has issued guidelines onward obstetric analgesia and anesthesia. ACOG Practice Bulletin No. 36 appears in the July 2002 issue of Obstetrics and Gynecology

Uterine contractions and cervical dilation rise in visceral pain, and as labor progresse the slope of the fetus's head and succeeding pressure on the pelvic floor, vagina, and perineum generate somatic pain transmitted by the agency of the pudendal nerve. Ideally, pain relief will ameliorate the pair sources.

The ACOG guidelines approve physicians make regional analgesia available during labor. Women with preeclampsia are potential candidates, unles a contraindication is existing as are women with platelet holds of 50,000 to 100,000 small rooms per mm3 (50 to 100 3 109 by L), although a platelet account is not necessary in patients without complications.

Contraindications include refractory maternal hypotension, maternal coagulopathy, maternal use of a once-daily dose of low-molecular-weight heparin within 72 hours, untreated maternal bacteremia, skin infection at the site of needle placement, and increased intracranial crushing caused by a mass lesion.

Parenteral pain medications for labor pain decrease fetal heart rate and can limit the physician's ability to interpret the fetal heart rate tracing, according to the guidelines.

COPYRIGHT 2002 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group