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Labor pain is an issue that has greatly concerned professionals related to the birth process. Throughout the history of modern obstetrics, different drugs have been used to alleviate it (intravenous, inhaled ...). In them, the one that has proven to be the most effective in relation to risk / benefit is epidural anesthesia.
Nevertheless it is not a technique without risks or complications, since we do not forget that it involves the insertion of a needle and catheter in the epidural space (nervous system); Through which we introduce different drugs that in turn can cause unwanted effects.
So we find that the risks can derive both from the puncture itself, and from the effects of the drugs on the mother and baby's body.
The complications that can appear cover a wide range from the rare and potentially dangerous to the very common.
Among the most frequent we can highlight the following:
- Mother's arterial hypotension: the drop in blood pressure not only causes discomfort in the woman, but can lead to bradycardia in the baby (which is called risk of loss of fetal well-being). It is usually managed by giving the woman more IV fluids.
- Slowing down or stopping the labor process: a very high percentage of women who choose this type of analgesia will need intravenous oxytocin administration.
- Loss of the ability to push: many times the cancellation of pain, brings with it a loss of sensation. Women do not know where to direct their push, or they do not feel the pressure of the baby's head.
- Post-puncture headache (Headaches). They usually manifest when the needle passes from the epidural to the spinal space and can last up to a week. It is advisable to drink water and lie down as long as possible. In some cases it is necessary to apply a blood patch.
- Loss of sensation in the bladder. Most women with epidurals will need intermittent bladder catheters to empty the bladder during labor.
- Shaking chills. They can be felt during and after labor.
- Pain in the puncture area. It is because the needle goes through several layers of muscle.
- Epidural analgesia failures: the reason is not known, but in some women it does not work, or the analgesia may be lateralized (in such a way that the pain is concentrated mainly in the non-sleeping area). The catheter is usually moved or the puncture is tried again.
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