Title: Message
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I have
assisted a woman who had ITP with coags <40. Dr's were very reluctant to use
an epidural and instead used a fentanyl PCA. This was very effective, she wasn't
too drugged and as fentanyl has a very short half life seemed to work well with
her, minmal effect on the infant at birth. Problem I had was with a senior
midwife who got her pushing way too early when I was at lunch. No urge to push
'but your fully dilated love hold your breath and push'. All I could imagine was
those very fragile alveoli/capillary vessels in the lungs rupturing and I would
have pink frothy sputum or the cerebral blood vessel bursting causing a major
cerebral event.
I
needed a good debrief after that one!
Cheers
Barb
From a different perspective, we have used a PCA
(Fentanyl) in labour when the mother has requested more painrelief than IM
Morphine and an epidural is contraindicated, eg this week- fetal death in
utero at 26 weeks, mother septic with bordeline then deteriorating
coags. Labour induced with Cervagem over 36 hrs then further 24 hrs of
Syntocinon. Mother could not cope with pain and circumstances any longer. This
situation is infrequent. I have never seen them used with a viable
baby.
Monica
----- Original Message -----
Sent: Thursday, November 04, 2004 9:32
PM
Subject: Re: [ozmidwifery]
Epidurals
My Goodness!!! A PCA in labour, that's
absolutely appalling.
Sally
----- Original Message -----
Sent: Thursday, November 04, 2004
9:29 PM
Subject: [ozmidwifery]
Epidurals
While on the subject of epidurals.... I read an article recently
about a study involving ewes which had epidurals during their
labour. They wouldn't mother their young. A new term I learnt
this year while doing a short contract in a private hospital was the
"cold epidural" - the epidural you have put in prior to the start of your
induction! Not sure how common this is in other places. Of
course if there is any problem getting the epidural in you can always have
a PCA of morphine. You can imagine the results of that - one very
"stoned" mother totally uninterested in her narcotised baby. Sad but
true.
Cheers
Michelle
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- RE: [ozmidwifery] Epidurals B & G
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