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The purpose of this study is to determine if a lateral positioning of the pregnant woman after epidural analgesia increases the incidence of unilateral functioning epidurals.
Pregnant women requesting epidural analgesia will be randomized to either left lateral or semi-recumbent position for 30 minutes after the first epidural bolus-injection.
After 30 minutes, the clinical effect of the analgesia will be evaluated by an anesthesiologist if available or by a midwife if the anesthesiologist is unavailable. The study-period is concluded thereafter and further positioning is optional.
Maternal and fetal wellbeing are continuously being monitored during the study period and complications/interventions registered. APGAR and CTG results during the intervention will be registered and evaluated at a later stage.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| semi-recumbent | No Intervention | rutine positioning at the hospital today | |
| lateral position | Experimental | experimental position to be evaluated against rutine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| lateral position | Procedure | patients placed on their left side after epidural catheter insertion |
|
| Measure | Description | Time Frame |
|---|---|---|
| unilateral analgesic effect | clinical judgement: mothers pain-sensation and cold sensation test | evaluation of epidural effect after 30 min |
| Measure | Description | Time Frame |
|---|---|---|
| maternal comfort and safety in regards to blood pressure and/or unexpected neurological effects from epidural analgesia | clinical judgement: mothers subjective wellbeing, bloodpressure and incidence of vena cava compression, neurological deficits from epidural | evaluation of epidural effect after 30 min |
| fetal/neonatal safety measured with CTG and APGAR score |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Carolina Samuelsson, MD, PhD | Region Skane, Head of the Department of Anesthesia and Intensive Care, University Hospital SUS | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital SUS | Lund | Skåne County | 22185 | Sweden | ||
| University Hospital SUS |
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cardiotocographic changes and APGAR-score evaluation |
| CTG from start of study until birth, APGAR 2, 5 and 10min after birth |
| Malmö |
| Skåne County |
| 20502 |
| Sweden |