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Master Thesis

Impact de l’analgésie péridurale sur la contractilité utérine

Abstract : Objective The main objective was to investigate the association between epidural analgesia (EDA) and post epidural uterine contractility. Secondary objective were to study the association between this decrease and the analgesics used, and the association between this decrease and the labor stage during the EDA injection. Methods We conducted a retrospective, single-center observational study in a cohort of 197 patients. This study was done at the Poissy Saint-Germain Hospital Center from July 4 to September 2, 2018. The data base was collected on informations found in the obstetric and anesthetic files. The included patients were all women who gave birth during the period when they presented spontaneous labor with EDA, with a fetus in cephalic presentation and without previous caesarean section. Contractility was assessed before and after EDA injection in this population, then in subgroups based on the analgesics used and the labor phase during EDA injection. Results The number of uterine contractions was significantly reduced between 20 and 50 minutes after EDA injection. It decreased from 3.1 contractions per 10 minutes before the EDA injection, to 2.9 20 to 50 minutes after the injection. From 50 to 60 minutes, there were 3.0 contractions but the decrease was not significant. This difference was found when the EDA was placed in the latent phase, but not when it was placed in the active phase. This difference was not found when the analgesic used was lidocaine. When levobupivacaine or many analgesics were used, there was a significant decrease in contractility only 20 to 30 minutes after EDA injection. Then this decrease was resolved. Conclusion Our study revealed a decrease in uterine contractility within 20 minutes after EDA injection, then resolved 30 minutes later. This contractility decrease depends on the labor phase during EDA placement and the analgesics used.
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https://dumas.ccsd.cnrs.fr/dumas-03233960
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Submitted on : Tuesday, May 25, 2021 - 10:49:04 AM
Last modification on : Saturday, May 29, 2021 - 3:35:10 AM

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  • HAL Id : dumas-03233960, version 1

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Émilie Rachet. Impact de l’analgésie péridurale sur la contractilité utérine. Gynécologie et obstétrique. 2020. ⟨dumas-03233960⟩

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