International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2004
Case ReportsEpidural analgesia for acute symphysis pubis dysfunction in the second trimester.
We report a case of severe symphysis pubis dysfunction in a parturient during her second trimester of a twin pregnancy. Symphysis pubis dysfunction produces pain, instability and limitation of mobility and function, of the symphysis pubis during pregnancy and labour. It is often under-treated. ⋯ This provided initial analgesia, breaking a vicious cycle of pain and muscle spasm. The benefits extended into the remainder of her pregnancy. Subsequently, simple analgesics and physiotherapy allowed control of pain until vaginal delivery 15 weeks later.
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Int J Obstet Anesth · Jan 2004
Breast-feeding problems after epidural analgesia for labour: a retrospective cohort study of pain, obstetrical procedures and breast-feeding practices.
Various clinical practices have been found to be associated with breast-feeding problems. However, little is known about the effect of pain, obstetrical procedures and analgesia on breast-feeding behaviour. We designed a retrospective study with a questionnaire concerning pain, obstetrical procedures and breast-feeding practices mailed to 164 primiparae in Lapland. ⋯ In the sub-sample, 67% of the mothers who had laboured with epidural analgesia and 29% of the mothers who laboured without epidural analgesia reported partial breast feeding or formula feeding (P = 0.003). The problem of "not having enough milk" was more often reported by those who had had epidural analgesia. Further studies conducted prospectively are needed to establish whether a causal relationship exists between epidural analgesia and breast-feeding problems.
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Int J Obstet Anesth · Jan 2004
Comment Letter Case ReportsPost dural puncture headache in an anticoagulated patient.