Monday, April 27, 2015

Painless births (birth with epidural)

With no pain, pregnant woman is much more relaxed, more cooperative and birth process is realized in much more favorable conditions for the mother, the baby and also for gynecological staff that leads the birth.

Dr. Ismet Joseph
Master of Anaesthesiology and Intensive Treatment
American Hospital
038 221 661/045 500 910
For most women in Kosovo is still an unachievable dream idea to have a normal birth and not to experience the pangs, according to their description are strong enough and often unbearable. A large part or we can say that most of them do not even know that it is possible to be born normal and not experience the pain, what makes the delivery process much more pleasant and cheerful.
In Kosovo, there is still a great reluctance for this method because of the stigma and insufficient knowledge about the advantages of this method.But, birth painless as possible, should be offered almost every woman us here.
What is actually the birth without pain with epidural?
This means placing a catheter into the epidural space in the lumbar region, through which administered local anesthetics (bupivacaine or ropivacaine), which is blocked by pain without stop uterine contractions processes that are essential to the delivery process.
Made epidural catheter placement in the epidural space at the L2-L3 or L3-L4, ie about 2 levels below the level where it ends spinal cord, ie the lowest level of the back, which makes it safe for injury spinal cord.
Also today medication used for the epidural birth without pain, it is possible that the patient walk in the birth process (walking epidural) proving that not extend the birth process when placed in the early stage of birth.
Advantages of birth without pain
With no pain, pregnant woman is much more relaxed, more cooperative and birth process is realized in much more favorable conditions for the mother, the baby and also for gynecological staff that leads the birth.
Also through the catheter epidural anesthesia can be accomplished even if the birth process there is a need of surgery (Caesarean), which avoids the risk of general anesthesia with all its possible complications.
What you need to realize a birth without pain?
1. anesthesiologist who has the knowledge and experience needed to administer the epidural catheter and birth without pain management.
2. The gynecologist who has the right experience in the management of birth without pain.
3. Tools needed for epidural catheter placement.
4. Medication necessary for the administration to realize the birth without pain.
5. Necessary monitoring of mother and fetus.
What to do before you realized a birth without pain?
1. It is imperative that a few days before birth to consult anesthesiologist who receives information from pregnant to her health condition, potential problems earlier and an explanation regarding the procedure of placing the epidural catheter.
2. Doing the analysis necessary precautions to eliminate any potential problems that will not allow or will make dangerous epidural catheter placement.
3. Information about each step that accompanies placement of the catheter and subsequent management of the birth without pain.
4. Establishing mutual trust in the patient-doctor.
To which women can be accomplished birth without pain with epidural catheter?
East painless epidural catheter can be done to all women except those that:
1. Have disease coagulation (clotting) of blood.
2. Infection at the catheter.
3. Intracranial hypertension.
4. Placenta previa, hematoma retroplacentare.
5. Unable continuous monitoring of fetal heart rate (RZF)
6. Suffering acute fetal requires urgent intervention.
The technique of placing the epidural catheter
1. Position sitting and rarely lateral
2. Finding the interspinoze L2 / L3 or L3 / L4
3. Skin disinfection Betadin
4. Setting sterile cover the hole
5. Skin infiltration with local anesthetic interspinoze space
6. Finding the epidural space with the loss of resistance method (low-resistance syringe filled with aqua Distillates)
7. After finding space, placement of the catheter 3-4 cm into the epidural space.
8. Fixation of the catheter
9. Aspiration test and giving the Lidokain test dose of adrenalin.
10. Start the administration of anesthetic to achieve a painless birth.
Epidural catheter is removed once the end of the birth process.

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