The position or orientation of the FETUS at near term or during OBSTETRIC LABOR, determined by its relation to the SPINE of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the NECK.
The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).
Artificially induced UTERINE CONTRACTION. Generally, LABOR, OBSTETRIC is induced with the intent to cause delivery of the fetus and termination of pregnancy.
The beginning of true OBSTETRIC LABOR which is characterized by the cyclic uterine contractions of increasing frequency, duration, and strength causing CERVICAL DILATATION to begin (LABOR STAGE, FIRST ).
Pain associated with OBSTETRIC LABOR in CHILDBIRTH. It is caused primarily by UTERINE CONTRACTION as well as pressure on the CERVIX; BLADDER; and the GASTROINTESTINAL TRACT. Labor pain mostly occurs in the ABDOMEN; the GROIN; and the BACK.
Onset of OBSTETRIC LABOR before term (TERM BIRTH) but usually after the FETUS has become viable. In humans, it occurs sometime during the 29th through 38th week of PREGNANCY. TOCOLYSIS inhibits premature labor and can prevent the BIRTH of premature infants (INFANT, PREMATURE).
Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.
Allowing a woman to be in LABOR, OBSTETRIC long enough to determine if vaginal birth may be anticipated.
The process by which antigen is presented to lymphocytes in a form they can recognize. This is performed by antigen presenting cells (APCs). Some antigens require processing before they can be recognized. Antigen processing consists of ingestion and partial digestion of the antigen by the APC, followed by presentation of fragments on the cell surface. (From Rosen et al., Dictionary of Immunology, 1989)
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
The final period of OBSTETRIC LABOR that is from the expulsion of the FETUS to the expulsion of the PLACENTA.
Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.
Extraction of the FETUS by means of abdominal HYSTEROTOMY.
Drugs that stimulate contraction of the myometrium. They are used to induce LABOR, OBSTETRIC at term, to prevent or control postpartum or postabortion hemorrhage, and to assess fetal status in high risk pregnancies. They may also be used alone or with other drugs to induce abortions (ABORTIFACIENTS). Oxytocics used clinically include the neurohypophyseal hormone OXYTOCIN and certain prostaglandins and ergot alkaloids. (From AMA Drug Evaluations, 1994, p1157)
The smooth muscle coat of the uterus, which forms the main mass of the organ.
The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.

The prognostic significance of hyperextension of the fetal head detected antenatally with ultrasound. (1/81)

OBJECTIVES: The purpose of this study was to evaluate the clinical significance of hyperextension of the fetal head detected by ultrasound prior to the onset of labour. METHODS: Over a 10-year period, we retrospectively identified all fetuses who had hyperextension of the fetal head reported on antenatal ultrasound. Hyperextension referred to persistence of the cervical spine in extreme extension, with an extension angle of at least 150 degrees persisting for the duration of the scan. Follow-up information was obtained from Hospital medical records and obstetrical care providers. RESULTS: Follow-up was obtained on 57 of the 65 fetuses (87.7%) identified over the study period. Ten of the 57 fetuses had normal structural fetal surveys and had sonographically identified resolution prior to delivery. All 10 patients delivered at term and had newborns with normal neonatal courses. Twenty-six of 57 fetuses had no sonographic findings other than persistent hyperextension, and 19 of these 26 fetuses (73%) had normal neonatal courses. Twenty-one of 57 fetuses (37%) had structural anomalies sonographically identified in addition to hyperextension of the fetal head. All 21 of these pregnancies ended in either termination or fetal or neonatal demize. CONCLUSIONS: Although resolution of isolated hyperextension of the fetal head is associated with a normal neonatal outcome, persistent isolated hyperextension of the fetal head can be associated with either a normal or an abnormal neonatal outcome. Fetuses with hyperextended heads and antenatally diagnosed structural anomalies have dismal outcomes. The identification of a fetus with hyperextension of the fetal head should prompt a detailed search for structural abnormalities.  (+info)

Use by general practitioners of obstetric beds in a consultant unit: a further report. (2/81)

Of 1,700 women booked for delivery by general practitioner obstetricians in a consultant unit, 1,399 had uncomplicated deliveries and the co-operation between practitioner and consultant was an obvious advantage for the 257 who were transferred completely to consultant care during pregnancy, labour, or puerperium. The scheme, which started in 1964, has enabled general practitioners to continue to give complete obstetric care to their patients. The number of participating practitioners has, however, declined from 80 to 16 indicating that many preferred to concentrate on antenatal work.  (+info)

Birth trauma to muscles in babies born by breech delivery and its possible fatal consequences. (3/81)

Dissection and histological examination was made of the muscles of 86 babies who died after breech delivery, and of 38 babies who died after vertex presentation. A control group of 50 surviving breech-delivered babies was examined clinically and the results compared. It was concluded that the most common type of birth trauma to a baby born by breech delivery is injury to muscles and soft tissues of the back and lower extremities, which is often extensive. In some severly injured babies histological examination of organs revels signs of crush syndrome and disseminated intravascular coagulation. It is suggested that the extensive muscle trauma forms the background of these fatal conditions.  (+info)

Is internal podalic version a lost art? Optimum mode of delivery in transverse lie. (4/81)

AIM: To study the changing trend in the delivery of transverse lie, and its effect on neonatal outcome, in a developing country. SUBJECTS AND METHOD: This is a retrospective study involving records of 12 years of all patients with transverse lie. Neonatal outcome of births by internal podalic version (IPV) and lower segment caesarean section (LSCS) were compared. RESULTS: In the first six years, 37.3% of transverse lie underwent IPV and 62.7%, LSCS. In the next six years, 15.8% underwent IPV and 84.2%, LSCS. 87.7% and 12.3% of live babies were delivered by LSCS and IPV respectively. 52% of the live born IPV were discharged compared to 95% of LSCS babies. Neonatal outcome was best when IPV was performed on second twin. CONCLUSION: IPV has a role in the delivery of second twin, pre-viable and dead babies.  (+info)

Intrapartum fetal head position I: comparison between transvaginal digital examination and transabdominal ultrasound assessment during the active stage of labor. (5/81)

OBJECTIVE: To test the null hypothesis that no correlation exists between transvaginal digital and the gold standard technique of transabdominal suprapubic ultrasound assessments of fetal head position during labor. A secondary objective was to compare the performance of attending physicians vs. senior residents in depicting fetal head position by transvaginal digital examination in comparison with ultrasound, respectively. METHODS: Consecutive patients in active labor at term with normal singleton cephalic-presenting fetuses were included. All participants had ruptured membranes, cervical dilation > or = 4 cm and fetal head at ischial spine station -2 or lower. Transvaginal sterile digital examinations were performed by either senior residents or attending physicians and followed immediately by transverse suprapubic transabdominal ultrasound assessments. Examiners were blinded to each other's findings. Power-analyses dictated number of subjects required. Statistical analyses included Chi-square, Cohen's Kappa test and logistic regression analysis. P < 0.05 was considered statistically significant. RESULTS: One hundred and two patients were studied (n = 102). In only 24% of patients (n = 24), transvaginal digital examinations were consistent with ultrasound assessments (P = 0.002, 95% confidence interval, 16-33). Logistic regression revealed that cervical effacement (P = 0.03) and ischial spine station (P = 0.01) significantly affected the accuracy of transvaginal digital examination. Parity, gestational age, combined spinal epidural anesthesia, cervical dilation, birth weight and examiner experience did not significantly affect accuracy of the examination. The accuracy of the transvaginal digital exams was increased to 47% (n = 48) (95% confidence interval, 37-57) when fetal head position at transvaginal digital examination was recorded as correct if reported within +/- 45 degrees of the ultrasound assessment. The rate of agreement between the two assessment methods for attending physicians vs. residents was 58% vs. 33%, respectively (P = 0.02) with the +/- 45 degrees analysis. CONCLUSIONS: Using ultrasound assessment as the gold standard, our data demonstrate an overall high rate of error (76%) in transvaginal digital determination of fetal head position during active labor, consistent with the null hypothesis. Attending physicians exhibited an almost two-fold higher success rate in depicting correct fetal head position by physical examination vs. residents in the +/- 45 degrees analysis. Intrapartum ultrasound increases the accuracy of fetal head position assessment during active labor and may serve as an educational tool for physicians in training.  (+info)

Intrapartum fetal head position II: comparison between transvaginal digital examination and transabdominal ultrasound assessment during the second stage of labor. (6/81)

OBJECTIVE: To test the null hypothesis that no correlation exists between transvaginal digital examination compared with the gold standard technique of transabdominal suprapubic ultrasound assessment of fetal head position during the second stage of labor. A secondary objective was to compare the performance of attending physicians vs. senior residents in depicting fetal head position by transvaginal digital examination in comparison with ultrasound assessment. METHODS: Consecutive patients in the second-stage of labor at term with normal singleton cephalic-presenting fetuses and ruptured membranes were included. Transvaginal digital examinations were performed by either attending physicians or senior residents and were followed immediately by transverse suprapubic transabdominal sonographic assessments performed by a single sonographer. Examiners were blinded to each other's findings. Power analysis dictated sample size. Exact binomial confidence intervals around observed rates were compared with chi 2 and Cohen's kappa-tests. Logistic regression was applied. P < 0.05 was considered significant throughout. RESULTS: One hundred and twelve patients were studied. The absolute error of transvaginal digital examinations was recorded in 65% of patients (95% confidence interval, 56-74%). Parity, pelvic station, combined spinal epidural anesthesia, length of first or second stages of labor, use of oxytocin augmentation, gestational age, mode of delivery, birth weight, and examiner experience did not significantly affect examination accuracy. Stratification, when the transvaginal digital examination was recorded as correct if occurring within +/- 45 degrees of the ultrasound assessment, reduced the error of the transvaginal digital examinations to 39% (95% confidence interval, 30-49%). Independent variables again did not affect examination accuracy in this assessment modality. Rates of agreement between the two methods for attending physicians compared with residents were not significantly different. The overall degrees of agreement were 40% (95% confidence interval, 26-55%) and 68% (95% confidence interval, 53-80%) (kappa = 0.25 and 0.30) for the absolute agreement and +/- 45 degrees assessment modalities, respectively, for attending physicians, and 31% (95% confidence interval, 20-44%) and 55% (95% confidence interval, 42-68%) (kappa = 0.14 and 0.12) for senior residents. CONCLUSION: Using ultrasound assessment as the gold standard, our data demonstrate a high rate of error (65%) in transvaginal digital determination of fetal head position during the second stage of labor. The performance of senior residents in transvaginal digital examinations did not differ significantly from that of attending physicians. Intrapartum ultrasound increases the accuracy of fetal head position assessment during the second stage of labor.  (+info)

Role of pelvimetry in active management of labour. (7/81)

All cases referred for pelvimetry in 1970-1 and all breech presentations referred for pelvimetry in 1972-4 were reviewed. Indications for pelvimetry fell into four main categories: high head in the antenatal clinic (47-8%); high head in labour (13-9%); breech presentation (20-9%); and previous caesarean section (14-8%). In the first two categories pelvimetry rarely if ever influenced management, and it should not be performed routinely. In breech presentation and cases of caesarean section pelvimetry seemed to be of value, but in the latter group it should be performed puerperally to avoid the known radiation hazard to the fetus. A fairly close correlation between obstetric conjugate and pelvic capacity was shown, which suggested that a 3400-g baby might pass through a pelvis of obstetric conjugate of 10 cm as a cephalic trial of labour, but would need an obstetric conjugate of 11-7 cm for safe vaginal breech delivery.  (+info)

Comparison of the perinatal morbidity and mortality of the presenting twin and its co-twin. (8/81)

OBJECTIVE: To compare the perinatal outcome of the presenting twin to its co-twin. STUDY DESIGN: All live nonanomalous twin gestations delivered at >25 weeks' gestation between 1984 and 1994 (N=461) were identified. Twin A was compared to twin B regarding the following variables: presentation, Apgar score (AS) <4 at 1 minute, AS <7 at 5 minutes, birth weight, gender, traumatic delivery, meconium-stained amniotic fluid, cord prolapse, need for mechanical ventilation, intraventricular hemorrhage, respiratory distress syndrome, sepsis, seizures, perinatal mortality, and length of nursery stay. RESULTS: Except for differences in presentation, the perinatal outcome was similar in both twins regarding variables studied. This continued to hold true after subdividing according to mode of delivery, when infants with birth weight < or = 1500 g were considered separately, and when vaginally delivered cephalic twin A was compared to the noncephalic co-twin. However, differences in some outcome variables became evident when pregnancies with only one affected member were analyzed separately. CONCLUSIONS: When all twin pairs are considered, the outcome of the second-born twin is similar to that of the first-born regardless of the mode of delivery, presentation, or birth weight < or = 1500 g. If only those twin pairs with one affected and one unaffected twin are considered, it becomes apparent that the presenting twin is at increased risk for infection-related morbidities whereas the co-twin is at risk for other complications.  (+info)

'Labor presentation' is a term used in obstetrics to describe the part of the fetus that enters the mother's pelvis first during labor. This positioning determines the route the baby will take through the birth canal. The most common and uncomplicated presentation is vertex or cephalic presentation, where the baby's head is the presenting part. Other possible presentations include breech (buttocks or feet first), face, brow, and shoulder presentations, which can potentially lead to complications during delivery if not managed appropriately.

'Labor, Obstetric' refers to the physiological process that occurs during childbirth, leading to the expulsion of the fetus from the uterus. It is divided into three stages:

1. The first stage begins with the onset of regular contractions and cervical dilation and effacement (thinning and shortening) until full dilation is reached (approximately 10 cm). This stage can last from hours to days, particularly in nulliparous women (those who have not given birth before).
2. The second stage starts with complete cervical dilation and ends with the delivery of the baby. During this stage, the mother experiences strong contractions that help push the fetus down the birth canal. This stage typically lasts from 20 minutes to two hours but can take longer in some cases.
3. The third stage involves the delivery of the placenta (afterbirth) and membranes, which usually occurs within 15-30 minutes after the baby's birth. However, it can sometimes take up to an hour for the placenta to be expelled completely.

Obstetric labor is a complex process that requires careful monitoring and management by healthcare professionals to ensure the safety and well-being of both the mother and the baby.

Induced labor refers to the initiation of labor before it begins spontaneously, which is usually achieved through medical intervention. This process is initiated when there is a medically indicated reason to deliver the baby, such as maternal or fetal compromise, prolonged pregnancy, or reduced fetal movement. The most common methods used to induce labor include membrane stripping, prostaglandin administration, and oxytocin infusion. It's important to note that induced labor carries certain risks, including a higher chance of uterine hyperstimulation, infection, and the need for assisted vaginal delivery or cesarean section. Therefore, it should only be performed under the close supervision of a healthcare provider in a clinical setting.

Labor onset, also known as the start of labor, refers to the beginning of regular and coordinated uterine contractions that ultimately result in the delivery of a baby. This is usually marked by the presence of regular contractions that increase in intensity and frequency over time, along with cervical dilation and effacement (thinning and shortening of the cervix).

There are two types of labor onset: spontaneous and induced. Spontaneous labor onset occurs naturally, without any medical intervention, while induced labor onset is initiated by medical professionals using various methods such as medication or mechanical dilation of the cervix.

It's important to note that the onset of labor can be a challenging concept to define precisely, and different healthcare providers may use slightly different criteria to diagnose the start of labor.

Labor pain is the physiological discomfort and pain experienced by women during childbirth, typically beginning in the lower back and radiating to the abdomen as contractions become more intense and frequent. It's primarily caused by the contraction of uterine muscles, pressure on the cervix, and stretching of the vaginal tissues during labor and delivery.

The pain can vary greatly among individuals, ranging from mild to severe, and it may be influenced by factors such as fear, anxiety, cultural expectations, and previous childbirth experiences. Various methods, including pharmacological interventions (such as epidural anesthesia), non-pharmacological techniques (such as breathing exercises, relaxation techniques, and water immersion), and alternative therapies (such as acupuncture and massage) can be used to manage labor pain.

Premature obstetric labor, also known as preterm labor, is defined as regular contractions leading to cervical changes that begin before 37 weeks of gestation. This condition can result in premature birth and potentially complications for the newborn, depending on how early the delivery occurs. It's important to note that premature labor requires medical attention and intervention to try to stop or delay it, if possible, to allow for further fetal development.

Obstetric labor complications refer to any physical or physiological difficulties that arise during the process of childbirth (labor) and can pose risks to the health of the mother, baby, or both. These complications may result from various factors such as pre-existing medical conditions, fetal distress, prolonged labor, abnormal positioning of the fetus, or issues related to the size or weight of the baby.

Some examples of obstetric labor complications include:

1. Fetal distress: This occurs when the fetus is not receiving adequate oxygen supply or is in danger during labor. It can be caused by various factors such as umbilical cord compression, placental abruption, or maternal anemia.
2. Prolonged labor: When labor lasts for more than 20 hours in first-time mothers or more than 14 hours in subsequent pregnancies, it is considered prolonged labor. This can lead to fatigue, infection, and other complications for both the mother and baby.
3. Abnormal positioning of the fetus: Normally, the fetus should be positioned head-down (vertex) before delivery. However, if the fetus is in a breech or transverse position, it can lead to difficult labor and increased risk of complications during delivery.
4. Shoulder dystocia: This occurs when the baby's shoulders get stuck behind the mother's pubic bone during delivery, making it challenging to deliver the baby. It can cause injuries to both the mother and the baby.
5. Placental abruption: This is a serious complication where the placenta separates from the uterus before delivery, leading to bleeding and potential oxygen deprivation for the fetus.
6. Uterine rupture: A rare but life-threatening complication where the uterus tears during labor, causing severe bleeding and potentially endangering both the mother and baby's lives.
7. Preeclampsia/eclampsia: This is a pregnancy-related hypertensive disorder that can lead to complications such as seizures, organ failure, or even maternal death if left untreated.
8. Postpartum hemorrhage: Excessive bleeding after delivery can be life-threatening and requires immediate medical attention.
9. Infections: Maternal infections during pregnancy or childbirth can lead to complications for both the mother and baby, including preterm labor, low birth weight, and even fetal death.
10. Anesthesia complications: Adverse reactions to anesthesia during delivery can cause respiratory depression, allergic reactions, or other complications that may endanger the mother's life.

A "trial of labor" (ToL) is a medical term used to describe the attempt to deliver a baby vaginally, without the use of a cesarean section (C-section), after a previous C-section delivery. It's also sometimes referred to as "VBAC" (vaginal birth after cesarean). The decision to undergo a trial of labor is made after considering several factors, including the reason for the prior C-section, the woman's overall health and pregnancy complications, if any.

During a trial of labor, the healthcare provider will monitor both the mother and the baby closely for signs of distress or other complications that might require an emergency C-section. The success rate of a trial of labor varies depending on several factors, including the number of previous C-sections, the reason for those C-sections, and whether there are any additional risk factors present in the current pregnancy.

It's important to note that while a trial of labor can be successful and result in a vaginal delivery, it also carries some risks, such as the possibility of uterine rupture, which is a serious complication that requires immediate medical attention. Therefore, the decision to undergo a trial of labor should be made carefully and discussed thoroughly with a healthcare provider.

Antigen presentation is the process by which certain cells in the immune system, known as antigen presenting cells (APCs), display foreign or abnormal proteins (antigens) on their surface to other immune cells, such as T-cells. This process allows the immune system to recognize and mount a response against harmful pathogens, infected or damaged cells.

There are two main types of antigen presentation: major histocompatibility complex (MHC) class I and MHC class II presentation.

1. MHC class I presentation: APCs, such as dendritic cells, macrophages, and B-cells, process and load antigens onto MHC class I molecules, which are expressed on the surface of almost all nucleated cells in the body. The MHC class I-antigen complex is then recognized by CD8+ T-cells (cytotoxic T-cells), leading to the destruction of infected or damaged cells.
2. MHC class II presentation: APCs, particularly dendritic cells and B-cells, process and load antigens onto MHC class II molecules, which are mainly expressed on the surface of professional APCs. The MHC class II-antigen complex is then recognized by CD4+ T-cells (helper T-cells), leading to the activation of other immune cells, such as B-cells and macrophages, to eliminate the pathogen or damaged cells.

In summary, antigen presentation is a crucial step in the adaptive immune response, allowing for the recognition and elimination of foreign or abnormal substances that could potentially harm the body.

Pregnancy is a physiological state or condition where a fertilized egg (zygote) successfully implants and grows in the uterus of a woman, leading to the development of an embryo and finally a fetus. This process typically spans approximately 40 weeks, divided into three trimesters, and culminates in childbirth. Throughout this period, numerous hormonal and physical changes occur to support the growing offspring, including uterine enlargement, breast development, and various maternal adaptations to ensure the fetus's optimal growth and well-being.

The third stage of labor is the period between the delivery of the baby and the expulsion of the placenta. It is also known as the afterbirth stage. This stage is typically completed within 5-30 minutes, but can take up to an hour. During this stage, the uterus continues to contract, causing the separation of the placenta from the uterine wall. Once separated, the placenta is expelled from the body with the help of contractions and a strong push from the mother. It is important for medical professionals to monitor this stage closely to ensure that the entire placenta is expelled and to manage any potential complications, such as heavy bleeding.

"Delivery, Obstetric" is a medical term that refers to the process of giving birth to a baby. It involves the passage of the fetus through the mother's vagina or via Caesarean section (C-section), which is a surgical procedure.

The obstetric delivery process typically includes three stages:

1. The first stage begins with the onset of labor and ends when the cervix is fully dilated.
2. The second stage starts with full dilation of the cervix and ends with the birth of the baby.
3. The third stage involves the delivery of the placenta, which is the organ that provides oxygen and nutrients to the developing fetus during pregnancy.

Obstetric delivery requires careful monitoring and management by healthcare professionals to ensure the safety and well-being of both the mother and the baby. Various interventions and techniques may be used during the delivery process to facilitate a safe and successful outcome, including the use of medications, assisted delivery with forceps or vacuum extraction, and C-section.

A Cesarean section, often referred to as a C-section, is a surgical procedure used to deliver a baby. It involves making an incision through the mother's abdomen and uterus to remove the baby. This procedure may be necessary when a vaginal delivery would put the mother or the baby at risk.

There are several reasons why a C-section might be recommended, including:

* The baby is in a breech position (feet first) or a transverse position (sideways) and cannot be turned to a normal head-down position.
* The baby is too large to safely pass through the mother's birth canal.
* The mother has a medical condition, such as heart disease or high blood pressure, that could make vaginal delivery risky.
* The mother has an infection, such as HIV or herpes, that could be passed to the baby during a vaginal delivery.
* The labor is not progressing and there are concerns about the health of the mother or the baby.

C-sections are generally safe for both the mother and the baby, but like any surgery, they do carry some risks. These can include infection, bleeding, blood clots, and injury to nearby organs. In addition, women who have a C-section are more likely to experience complications in future pregnancies, such as placenta previa or uterine rupture.

If you have questions about whether a C-section is necessary for your delivery, it's important to discuss your options with your healthcare provider.

Oxytocics are a class of medications that stimulate the contraction of uterine smooth muscle. They are primarily used in obstetrics to induce or augment labor, and to control bleeding after childbirth. Oxytocin is the most commonly used oxytocic and is naturally produced by the posterior pituitary gland. Synthetic forms of oxytocin, such as Pitocin, are often used in medical settings to induce labor or reduce postpartum bleeding. Other medications with oxytocic properties include ergometrine and methylergometrine. It's important to note that the use of oxytocics should be monitored carefully as overuse can lead to excessive uterine contractions, which may compromise fetal oxygenation and increase the risk of uterine rupture.

The myometrium is the middle and thickest layer of the uterine wall, composed mainly of smooth muscle cells. It is responsible for the strong contractions during labor and can also contribute to bleeding during menstruation or childbirth. The myometrium is able to stretch and expand to accommodate a growing fetus and then contract during labor to help push the baby out. It also plays a role in maintaining the structure and shape of the uterus, and in protecting the internal organs within the pelvic cavity.

Epidural analgesia is a type of regional anesthesia used to manage pain, most commonly during childbirth and after surgery. The term "epidural" refers to the location of the injection, which is in the epidural space of the spinal column.

In this procedure, a small amount of local anesthetic or narcotic medication is injected into the epidural space using a thin catheter. This medication blocks nerve impulses from the lower body, reducing or eliminating pain sensations without causing complete loss of feeling or muscle movement.

Epidural analgesia can be used for both short-term and long-term pain management. It is often preferred in situations where patients require prolonged pain relief, such as during labor and delivery or after major surgery. The medication can be administered continuously or intermittently, depending on the patient's needs and the type of procedure being performed.

While epidural analgesia is generally safe and effective, it can have side effects, including low blood pressure, headache, and difficulty urinating. In rare cases, it may also cause nerve damage or infection. Patients should discuss the risks and benefits of this procedure with their healthcare provider before deciding whether to undergo epidural analgesia.

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