View Entire Collection
By Clinical Topic
By State Requirement
Diabetes – Summer 2012
Future of Nursing Initiative
Heart Failure - Fall 2011
Influenza - Winter 2011
Nursing Ethics - Fall 2011
Trauma - Fall 2010
Traumatic Brain Injury - Fall 2010
Fluids & Electrolytes
THURSDAY, April 29 (HealthDay News) -- Frequent epidural anesthesia doses needed by women who attempt vaginal delivery after cesarean delivery (VBAC) may indicate an increased risk for uterine rupture, according to research published in the April issue of the American Journal of Obstetrics & Gynecology.
Alison G. Cahill, M.D., of the Washington University School of Medicine in St. Louis, and colleagues conducted a nested, case-control study of 804 women with a history of cesarean delivery, 134 of whom experienced a uterine rupture during a VBAC trial. The other 670 women were controls. They compared the dose timing, frequency, and quantity of epidural anesthesia between the two groups to estimate the association between epidural dosing and the risk of uterine rupture.
Of the 804 women, the researchers found that 504 (62 percent) received epidural anesthesia, and there was no statistical difference between cases and control subjects in use of epidural. Rates of uterine rupture were higher in those who received more epidural doses, with hazard ratios of 2.8, 3.1, 6.7 and 8.1 for one, two, three and four or more doses, respectively. There was also evidence of increased epidural dosing in the final 90 minutes of labor in women who had a rupture.
"Our findings support the notion that epidural anesthesia does not mask uterine rupture and that the dosing requirements can be viewed as a clinical objective sign, particularly those that increase in number over a 90-minute period," the authors write.
Full Text (subscription or payment may be required)
Sign up for our free enewsletters to stay up-to-date in your area of practice - or take a look at an archive of prior issues
Join our CESaver program to earn up to 100 contact hours for only $34.95
Explore a world of online resources
Back to Top