• P J Angle, V Ashok, G Liu, M Trenholm, and J Montbriand.
• Department of Anesthesia, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada; Institute for Health Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Obstetrical Anesthesia Research Unit (OARU), Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: pamela.angle@sunnybrook.ca.
• Int J Obstet Anesth. 2024 Mar 28: 103992103992.

AbstractShower hydrotherapy is generally considered benign during labor. We report a case of extensive scalds in a primigravida who used shower hydrotherapy to treat severe back labor pain from fetal malposition. Interestingly, her back pain was so severe that she felt no pain as her scald developed, describing the hot water from the showerhead as the only measure which "soothed" her pain. Her scald was diagnosed presumptively during assessment for epidural analgesia. The nature of her back labor pain, associated with occiput posterior fetal head position and her management are described. Severe pain from persistent fetal malposition may alter somatic pain perception during labor, increasing burn risks during shower hydrotherapy. These women are also at increased risk of operative delivery and infection risks from inadvertent neuraxial blockade after burns. Improved prevention strategies and vigilance for scalds are warranted in women with severe back labor undergoing shower hydrotherapy, including by anesthesiologists assessing them for neuraxial blockade.Copyright © 2024 Elsevier Ltd. All rights reserved.

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