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Woman who control epidural dosing use less

A new study indicates that women who are given control of the amount of medication administered by an epidural use less than women who are administered a continuous amount. This revelation is important as the higher levels of the medications provided by an epidural are associated with an increased instance of assisted deliveries using vacuum or forceps, prolonged labor and a higher frequency in cesarean section births.

An epidural generally delivers a mixture of drugs and is an effective means of reducing pain during childbirth. While an epidural is generally a safe procedure, using more medication than is necessary during childbirth may expose the mother and the infant to unneeded risks.

According to the study, conducted by the Long Beach Medical Center in California, women who controlled the amount of medication used 30 percent less than those who received a continuous supply. Those who controlled the release of the epidural anesthesia were able to press a button every 20 minutes to receive additional medication. The self administering group reported that they remained relatively comfortable during the labor, but did report more pain than the other group during the pushing phase.

While every delivery is unique, reducing the likelihood that some intervention is necessary may avoid some serious risks. Forceps and vacuum extraction can pose a risk of skull fractures, internal bleeding, or swelling of the infant's head. Currently, about 30 percent of hospitals have transitioned to patient controlled epidurals.

The study was presented last week at the annual meeting for the Society for Maternal-Fetal Medicine.

Source: Time "Pregnant Women Who Control their Epidural Dosage Use Less Medication" Bonnie Rochman, February 10, 2011

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