Tuesday, 8 September 2015

Fluid therapy in pregnancy and childbirth

What is sueroterapia?
Intravenous fluid therapy is a term used to define the administration of fluids through a vein.
The fluid therapy is one common medical intervention in the treatment of any patient who is hospitalized. These liquids are introduced drug can be added if necessary, the dose will be regulated according to the number of milliliters when it is administered to the patient.
What kind of liquid form the basis of serum therapy?
There are a variety of sera available to the physician, according to want to have an effect on the patient or another, but the most used are liquid with a larger base of sugar or salt-rich. The different serums are designed to contribute whatever is necessary for the patient at all times, and its proper use does not significantly alter the concentration of other substances that also circulate in the blood.
Know more
See our 'section Pregnancy and Childbirth 'numerous related articles.
Follow your pregnancy ...
... Week to week. See when you grow nails or when the light perceived.
What fluid therapy used in pregnancy?
The fluid therapy in pregnancy is used with the same as for any other patient therapeutic purposes, but unique circumstances of pregnant women, such as the induction of labor or stimulation.
What is medication to induce labor?
When a woman is not in labor , but the gynecologist decides to initiate labor, either maternal or fetal risk problems, there is a substance administered through the vein helps the woman goes into labor; this substance is oxytocin.
How does oxytocin?
Oxytocin is a substance which is released naturally in the time of delivery, and acts causing uterine contractions.
When it induces or stimulates childbirth, usually begin with small doses gradually will be increased depending on the response to closely monitor what uterine contractions of the mother and fetal tolerance to these contractions is observed.
Other uses of sueroterapia
  • A common occurrence in obstetric practice is the need to stop preterm labor, ie a fetus less than 37 weeks. For the treatment of preterm labor drugs that try to stop the contractions that women have used these cases. This treatment is often being done with sera introduced intravenously.
  • There is a condition called hyperemesis gravidarum , which requires fluid therapy for resolution. Hyperemesis gravidarum is uncontrollable, continuous vomiting, which impair the general condition of the mother and are accompanied by progressive weight loss. This situation is resolved with the administration, through the veins of these fluids and nutrients that the patient can not tolerate oral.
  • A circumstance in which the fluid therapy plays, once again, an essential role is at the time of control situations of excessively high stress in pregnancy, endangering their lives and that of the fetus.

Childbirth: what to take to hospital

What important objects should wear?
Doctors are the most important documents not forget! And others have ready:
Make sure that besides you, there is a next person who knows where all this is in order that it may provide in case you can not take it to childbirth triggered unexpectedly away from home.
  • Your health care primer: Social Security, private assistance, or both, if you have both.
  • National identity document. It is necessary to extend the birth certificate and complete the formalities of registration in the book of family and civil registration.
  • Photocopies of their medical records, medical history or if available. Keep the originals at home. When the end of pregnancy approaches can be very useful to have a full medical report and to prepare you updated your doctor.
  •  
  • Reports of allergies should receive special attention.
  • The maternal primer evolutionary birth control. It referred to accurate data on the time of delivery as well as maternal education sessions that assisted to the parent or other family member who has chosen to accompany him at the time of delivery is made.
  • Images of the ultrasound made ​​available to it during visits.
  • Some certificates that guarantee that a person has received a minimum number of maternal education sessions as accompanist are sold in some centers. Always have it prepared to take, they may request it to allow entry of companion you have chosen.
  • Have a minimum of medication you may need. Sometimes they take medications for unusual use and should not risk stopping treatment.
  • Contact phone or warning means for gynecological and / or midwife, if that question has agreed with the same and that is their wish.
  • Other elements that want to take are: a vanity, makeup, hygienic pads (not tampons), underwear, slippers and a robe.
  • It may be a good idea to bring some clothes for after the birth. After all, it will be the first opportunity after months to get something other than maternity clothes.
  • It is quite practical to wear a bra for breastfeeding, as it is more convenient to take one normal and reinserting when when you finish breastfeeding the baby.
Do you like music?
If you like music, you can take some of your favorite CDs or cassettes to hospital. Some studies suggest that music helps to relax and is very relaxing.
Of interest
See our 'section Pregnancy and Childbirth 'other valuable articles:
  • The delivery (general)
  • Childbirth: Women options
  • Am I in labor?
He likes to read?
Sometimes, time passes slowly when you are in labor; This can be handy for some books or magazines. If you are tired, you can read his companion.
Who will accompany you?
Some women prefer to give birth alone. Others may not be to everyone around them that they would like in such a memorable occasion. The woman who will give birth is the one who decides who would like to be present. When you begin the first signs of the onset of labor, let that person know so that they have sufficient time to be made available.
Make a wish list for the time of delivery
It is interesting to conduct a "birth plan" highlighting the way you want to elapse delivery. Factors to consider include:
Write it all for the doctor and the midwife have the opportunity to know the plan. When the actual time of delivery comes, she may be too exhausted or absorbed by what happens to remember the exact details. Also remember that you may need to change some aspects of the plan if complications arise. Make sure there is another person of his full confidence and availability to meet all these personal details.
  • The way of pain relief. Find out if they offer the epidural anesthesia in the center where you want to give birth.
  • Lighting Type / environment that can offer the desired center.
  • Where will you put the baby after birth; for example, most women want to place your baby on his chest immediately after birth.
  • Who is allowed to pass the delivery room.
What should I bring for my baby?
Some women may not want to bring baby items to the maternity ward, but may be a good idea to have a bag ready for the ride home from the hospital. This could include:
  • Diapers
  • Underwear
  • A set of clothes for the mother and baby for the drive home
  • If you bring the baby home it is a good idea to have prepared a cot and a blanket or shawl transport. You must be securely attached so you can transport the baby safely and comfortably.
Would you like to call?
After birth, the parents probably want to share the good news with others. There is always allowed to use mobile phones in hospitals because they can interfere with the operation of some electronic equipment. Therefore, remember to take coins or phone cards and phones a list of all those people who would cheer at the news of such a good event.

Childbirth

What is a normal and natural childbirth?
Most pregnant women give birth without complications.
The onset of labor usually presents the start of periodic or regular and painful uterine contractions. They feel like jerks in the back, across the top of the uterus. Sometimes fluid bag baby breaks before the start of contractions or, more commonly, after labor has begun.
Often a mucous material is expelled from the vagina to the onset of labor (mucous plug) may contain traces of blood. Some women may begin to expel the stopper days before you actually go into labor and others do not expel, so it is not a reliable sign of labor.
During a natural birth the uterine muscles contract and this contraction is what is known as labor pains. Childbirth is a painful experience but breathing and relaxation techniques learned in preparation classes can make this something less stressful experience.
 
 
The contractions cause the baby's head is pressed down through the pelvis and against the inside of the cervix. Thus, the cervix is ​​dilated, and allows the baby's head down into the vagina and the outside world.
The role of the midwife during natural childbirth is to guide, provide support and check that everything goes well. It is very important to ascertain that the mother feel safe and find the experience of giving birth as rewarding as possible.
The first stage of labor or expansion period
This phase begins when labor contractions begin to be as frequent, intense and long enough to cause the cervix to open. At the onset of labor, usually externally examine women (abdominal scan), to see how the baby is facing and to confirm that your head is down.
The internal examination is conducted to check on the cervix (the cervix). Before labor begins, the cervix is ​​about 3 cm long and is not dilated. When labor begins, the cervix is ​​shortened (a process called effacement) and opens or expands. It is said that the cervix is ​​fully dilated when open 10 cm. It is important that the mother begins to not push before you are fully dilated and the danger of tearing of the cervix.
When this expansion of 10 cm is reached is considered completed the first stage of labor is about to start the second. The first stage usually lasts up to 12 hours in a first delivery and in the following seven hours, but every birth is different.
In turn, this expansion phase or it characterized by different periods:
  • Reach three centimeters dilated usually take most of time this period.
  • From three to eight or nine centimeters usually fast (during acceleration).
  • It becomes slow from eight or nine to reach full dilation (slowdown).
Related Articles
See our 'section Pregnancy and Childbirth 'articles of interest:
  • Childbirth: options
  • Childbirth: what to bring to the hospital
  • Am I in labor?
When you born?
See here the due date.
Follow your pregnancy
Take our test and find out when it will begin to suck his thumb or when you grow nails
The second stage of labor
The second stage begins when the cervix is ​​fully open (dilated 10 cm). The woman usually has the feeling of fullness in the vagina or belly and want to push. Most women find the pain more bearable in this second phase as they can now relieve themselves by pushing.
The second stage of labor ends with the baby out into the world. It usually lasts 45 minutes to 2 hours in a first childbirth and 15-45 minutes in successive deliveries.
The third stage of labor
This phase ends with the expulsion of the placenta, umbilical cord and membranes, postpartum. Normally, the placenta is delivered between 5 and 15 minutes after birth. The last phase of childbirth is a cooperation between the new mother and the midwife or obstetrician, but little effort is required to deliver the placenta.
Is a routine action administer an injection to the mother to stimulate the contraction of the uterus after childbirth and before the expulsion of the placenta. By causing the uterus to contract, the risk of excessive blood loss is reduced during placental delivery (post partum hemorrhage). Sometimes the placental not done spontaneously obstetrician having to proceed to extraction with one's hand and under analgesia and / or anesthesia .
What are the normal stages of a normal delivery? Who will be present during labor?
When childbirth takes place is usually sufficient assistance team which midwives attending the mother at birth and later the newborn to apply first-aid treatment. When problems or risk to the child or the mother is present, the medical team will consist of the obstetrician, midwife, anesthetist and pediatrician. Given a normal birth the medical staff will provide the couple or a trusted family member accompanying the mother in the delivery room.
How the mother and baby are monitored during labor?
The mother's blood pressure, pulse and temperature are checked at regular intervals throughout labor and beyond. The baby monitor is normal hearing the beating of his heart. It normally takes place listening to the heart with a special manual recording amplifier and heart rate at regular intervals during labor.
In certain circumstances it is necessary to have a continuous record of the baby's heartbeat. It can be obtained by a belt placed around the waist of the mother or with a small electrode placed on the baby's scalp through the uterus and vagina of the mother neck.
In analyzing the baby's heartbeat by these methods midwife or obstetrician can detect if the baby is getting enough oxygen during labor.
Sometimes the beat pattern shows abnormalities and may be necessary for the obstetrician take a small blood sample from the baby's scalp to analyze the oxygen content of the fetus (fetal making Ph).
Breech
In a breech baby it is placed in the uterus so that the head is near the mother's ribs and buttocks on the cervix. Because the baby's buttocks are slightly smaller than the head, it can be difficult to give birth safely. An alternative is to gently turn the baby before labor begins (known as external cephalic version), so it is head down when labor begins. This maneuver today is almost obsolete as they are not without risks and difficulties involved.
In all breech delivery should be represented by an obstetrician at the time of the expulsion of the baby that may occur due to maternal or fetal complications of obstetric practice maneuvers for removal or necessitating having to use the forceps to remove the baby's head remains trapped after the departure of the body.
In most obstetric services is common indicate cesarean in first whose baby is positioned buttocks; however, if not first-time and meet a number of conditions, vaginal delivery is normally permitted. This approach is currently being revised, since in obstetric services in the vaginal breech delivery in gilts is allowed, experience shows that they are normal and no increased fetal risk births when cases are selected. Many breech babies are born safely and mothers who have had a normal delivery will have less complications.
Delivery with forceps or vacuum (suction cup)
Between 5 and 20% of all births require the help of forceps or suction cup. This type of birth is known as instrumental birth. We carried out an obstetrician, who will use forceps or suction only in certain circumstances. The instrumental birth takes place only in the second stage of labor.
The most common reasons for the use of forceps or suction are:
When an instrumental birth is necessary, the doctor places the forceps or suction cup on the baby's head and pulls with great care to facilitate their departure.
Using forceps or suction cup, you may need to make a cut, also known as episiotomy, in the perineum of the mother (the area between the vagina and anus).
The first few days after birth, the baby will have the marks on the places where forceps or suction cup is placed, but these disappear quickly and are not of major importance.
If the use of forceps or vacuum is unsuccessful, it may be necessary to perform an emergency cesarean.
  • The infant has a record of abnormal heart rate, suggesting lack of oxygen (fetal failure).
  • The mother has spent much time pushing, it is exhausted and weak to continue doing so, being very engaged and head low.
  • The baby's head is in a little normal position in the pelvis anticipating that the expulsion of the fetus is too slow.
  • Avoid overexertion well women have scars from previous caesarean sections or other intervention on the uterus (the previous scar to have lower risk of rupture) or relief efforts that would aggravate certain maternal diseases ( heart failure, serious, etc.)
Gas (nitrous oxide) and oxygen
It can be used during labor and is particularly useful in the first phase. There are no major side effects for the mother or baby, and if the correct technique is still a good analgesia can be achieved.
Morphine or pethidine
These drugs are potent in relieving the pain administered by intramuscular injection. Serious side effects are rare. Mild side effects are that the mother may feel sleepy, develop itchy nose or feel nauseous. The drugs enter the baby's bloodstream and occasionally it can be a little slow to begin breathing at birth. If this is the case, the midwife or doctor will administer an antidote baby drug called naloxone to reverse the effects of the analgesic. These painkillers are administered once or twice during delivery and no risk of addiction for patients.
Epidural and spinal anesthesia
These techniques are administered by anesthesiologists. Both involve injecting an anesthetic through a needle near the spine in the lumbar region of the back. Usually they provide excellent pain relief without being very upset its inception. Rarely it is contraindicated by severe spinal problems, infection in the area concerned, severe maternal bleeding or suspected neurological disease.
The epidural is durable and can be administered even early in labor. It will last all the time until birth. A spinal anesthesia is used for a short period of time, ie for a birth with forceps or a Caesarean.
Serious side effects are rare epidural or spinal, and both midwives and anesthesiologists are specially trained to monitor their appearance. Epidurals do not slow delivery but sometimes to make women more effectively push hard in the second phase (to not feel the pain of contraction), increasing the need for forceps or vacuum extraction to baby.
Birth and pain relief medication (analgesia)
There are different types of pain relief that can be offered to women during childbirth. Some women decide in advance who do not want to use any analgesic method, but during labor can change their minds. Analgesia prescribes a doctor or midwife after a conversation with the woman. The most commonly used drugs are:
Tears in the vagina or perineum
To prevent serious tears that may incapacitate eventually produce usual doing a cut or episiotomy near the line between anus and vagina. After birth the child proceeds practiced suturing the cut. Many women are worried thinking for cuts and lacerations heal after birth, but fortunately most do.
The majority of women are given local anesthesia in the perineum and vagina or some other anesthetic before receiving points. Absorption sutures (removes the body) so that no points have to be removed days after used.
What if the muscle of the anus (anal sphincter) tears?
Very few women suffer a torn anal sphincter during delivery. Usually this happens only if the baby in very large, and sometimes can desgarrase when the doctor uses forceps or suction cup.
The doctor can suture the sphincter and women usually done while under the influence of a general spinal anesthesia, epidural or because it can be very painful.
If women experience some form of incontinence after the birth, you should consult your doctor.
Why do some births end in an emergency cesarean?
Some births require an emergency cesarean is practiced if unexpected complications arise and the baby shows signs of oxygen deprivation. If delivery takes place very slowly cesarean it will usually be necessary.
Every birth is different and every experience in those moments will be too. However, most births are normal and natural and most women willingly accept to go through it if its purpose is to have more children.

When labor starts?

There are many causes that are involved in the onset of labor ; throughout pregnancy, women suffer physiological changes that are preparing for that moment, and become more evident in recent weeks. What I can notice in recent weeks before delivery?
In the last period of pregnancy women experience a decrease abdomen, indirect sign of engagement of the fetus, by relieving the pressure produced in ribs and stomach, and feeling a greater weight in the lower region of the pelvis; this causes the woman is still empty the bladder more frequently.
Throughout these weeks, contractions that was already feeling will intensify and increase their frequency. The patient is probably more tired than the previous weeks, the unrest generated by intermittent pain of contractions, sometimes even impossible, the nightly rest .
 
Of interest
We suggest reading some related articles:
  • Epidural anesthesia
  • Caesarean section
  • Childbirth: Women options
  • Childbirth
  • Childbirth: what to take to hospital
What day will be born?
See here some key dates and the probable date of birth.
How will I know I'm in labor?
Almost all women are uneasy not knowing exactly when are initiating labor and when to go to hospital. A first sign is the bloody show that has been forming in the cervix during those nine months; removal of the cap does not imply an impending birth, but a preparation of the way towards it. You may eject to eject the plug something dark, even some bloody; It should not panic, as this is absolutely normal. It is likely to suffer further then followed and more intense contractions and whose sole purpose is to modify the cervix to start delivery.
The mother will be familiar with contractions during pregnancy and know distinguish them from any other pain, to see how your belly hardens and then returns to its normal situation.
Labor contractions must have special characteristics of regularity in time, that is, two or three of considerable intensity contractions every 10 minutes.
When I go to the hospital?
As we saw in the previous section, the woman must assume that labor is 2 or 3 when suffering major contractions intensity every ten minutes, but we must warn the mother that there are cases where even not having contractions of these features you must go to the hospital. These situations are:
In any case, if you have any questions or problems, think there will always be a team willing to deal with it.
  • If you think you have broken the bag, that is, if he receives involuntary loss of liquid and does not relate to the urine. This means that it has broken the amniotic sac surrounding the fetus, which is popularly known as "water breaking".
  • If you have started to bleed as if he had the rule.
  • If your obstetrician had informed him that will be practiced one cesarean for this pregnancy, and deadlines have been met.
  • If you stop feeling fetal movement.
  • If you are in poor general condition or fever with no apparent cause.
  • If you have a constant and painful contraction unyielding.
  • If you have a history of very fast delivery.
What factors should be taken to say that I'm in labor?
Arriving at the hospital or the place where you go to give birth, the obstetrician or midwife will explore and observe the state of the cervix, and recorded in the frequency and intensity of contractions. They also checked the welfare of the fetus.
They communicate in labor when they observe regular, moderate-intensity contractions and the cervix has changed, becoming soft consistency, focusing respect to the vagina and erasing its thickness. He is currently in labor.

Caesarean section

What is a cesarean section?
Caesarean section is the delivery of the child through the mother's abdomen by making an incision (wound) in this wall (laparotomy) and uterus (hysterectomy).
Normally a transverse abdominal incision is made in the lower abdomen and that although it is technically more difficult be offset by more aesthetic.
The relative safety of the Caesarean increased the percentage of births that ended this procedure. It is estimated that between 10 and 20% of all births are by cesarean section. But the fact of not being free of hazards (loss of health and even life of the mother) and that complications occur more frequently during Caesarean section with vaginal delivery, only practice makes indicated cesarean when there is a strict medical indication.
 
A C-section may be planned in advance (elective), or when a problem of maternal or fetal health and advises or may arise the need to perform caesarean section more or less immediate complications or difficulties in childbirth form. Elective caesarean is usually done one or two weeks before the expected date of birth. This ensures that the baby is sufficiently developed and mature to live alone outside the womb.
Elective caesarean section or one that is programmed in advance for a particular date
  • When there is a history of two previous cesarean sections or individual interventions scars on the uterus where this is fully opened.
  • The placenta is placed on the outlet of the uterus thereby preventing vaginal birth of the child. This is called placenta previa .
  • When the obstetrician or midwife before delivery discovers a situation that potentially threaten the child's life from lack of oxygen if you are expose himself to labor.
  • When coexisting with pregnancy maternal disease such that the effort it demands labor can unbalance or worsen their health (eg, heart failure, moderate or severe).
  • If because the big boy (macrosomia), present it any malformation or the maternal pelvis is too narrow or deformed the possibility of a vaginal delivery is presumed impossible (situation called cephalic-pelvic disproportion).
  • Current or very recent infection of the external genitalia by herpes virus , trying to avoid transmission to the fetus during passage thereof through the vagina.
Epidural, yes or no?
The epidural anesthesia is safe and reliable, but not without risks. Read about it.
Urgent cesarean indication during pregnancy or childbirth
  • When the placenta detaches from the uterus still widely it is finding the child within the same (early detachment of normally inserted placenta).
  • If severe vaginal bleeding occurs and it is expected that delivery can not happen immediately.
  • Seizure of pregnancy ( eclampsia ).
  • Sudden departure of the uterus cord standing in front of the child's head, a situation that is called cord prolapse.
  • Suspected uterine rupture before labor or during delivery if rapid expulsion of child vagina is not expected.
Indication of cesarean delivery during
  • Child misplaced (eg transversely located).
  • If no expansion, despite having the appropriate stem for a reasonable time contractions.
  • Failure stimulation of labor with oxytocin (hormone substance commonly used to produce uterine contractions).
  • Disproportion between maternal pelvis or suspected fetal head during childbirth.
  • Signs of fetal distress that does not yield to treatment.
  • Maternal fever during labor, provided it is presumed that vaginal delivery will be slow.
  • Sometimes there will be high-risk situations (eg, history of previous stillbirths, first pregnancy at an advanced age, previous sterility treatment, etc.) which, together with the above may establish an indication for cesarean section.
When a cesarean is necessary?
Overall Caesarean sections can be classified into three types:
Women must therefore be aware that CS must always have a medical indication to justify it and never will be performed following the patient without further.
What happens during a caesarean?
In a cesarean is the surgeon and his assistant, anesthetist, the scrub nurse's another nurse, a midwife and pediatrician.
In Spain the presence of the couple or a family member is not permitted during the making of it, even if it is practiced by epidural anesthesia.
An abdominal incision of 15 to 20 cm which can be cross in the lower abdomen and near the (most common) or vertical midline of the abdomen from the navel to the pubic hair pubic hair practice. After the opening of the various layers of tissue that make up the abdominal wall into the uterus leads on which a transverse incision which allows opening and through which the child is extracted practiced. The whole process lasts until birth a few minutes.
After birth, the umbilical cord is cut and the baby to his mother shown, if feasible and it remains awake. After removal of the placenta, the obstetrician closes the incision of the uterus and abdominal wall layer by layer; to reach the skin suture this is usually done with silk sutures visible but there is the possibility that intradermal sutures or staples and calls that go into the skin without being visible in use. Staples or silk must be removed after six or seven days, whereas the intradermal suture is biodegradable does not require removal.
In general, the duration of uncomplicated caesarean section is 30-40 minutes.
What you feel during a cesarean section?
Most anesthetists practice a spinal or epidural anesthesia using a thin needle which is situated in the lower half of the column. Most women will experience a feeling of pressure during cesarean section, but will not feel pain. You may be advised one anesthesia usually in certain circumstances where anesthesia epidural is contraindicated or maternal health status requires it, eg hypotension bleeding.
What are the risks of cesarean section?
A cesarean section is a safe operation for both mother and child. However, as in some surgical operations of importance, there risks. The main ones are for the mother and include severe bleeding during surgery or wound infection of the urinary tract , development of blood clots (thrombosis in the veins of the legs or pelvis) after delivery.
Further complications arise from the use of anesthesia, others are derived from neighboring viscera injury to the uterus (bladder, intestine, ureters). The obstetrician and midwife will ensure appropriate measures to reduce the risk of developing these complications or should be established for healing measures.
What happens after cesarean?
Most of the women get up and stand at 24 hours of CS, which is highly desirable for the prevention of thrombosis by immobility. Wound pain is controlled with the right soothing. Most mothers leave the hospital or clinic 4 or 5 days after cesarean delivery. On the third day postpartum women can receive showers without prejudice to the wound.
A C-section does not prevent a mother feeds her child to breastfeed, if that is your desire. Like after vaginal delivery after cesarean section you can have the "wrongs" which are intermittent pain caused by contraction of the uterus.
In general, the woman reaches her usual pre-pregnancy at six months postpartum weight. Exercise will help the recovery of your figure.
The sex with intercourse may start three weeks fulfilled caesarean section.

Epidural anesthesia

What is epidural anesthesia?
Epidural anesthesia, which is also known as nerve root anesthesia, is used to numb the nerve roots leaving the spinal cord. This is accomplished by injecting a local anesthetic or analgesic (pain medication). It is commonly used during childbirth to relieve the pain of it, and has recently introduced its use also in surgery to prevent pain that occurs after some operations and reduce complications such as lung infections and thrombosis in the legs lack of mobility.
During childbirth , epidurals usually begins when there are contractions and is administered once the cervix has begun to dilate. It is completely effective in about 96% of cases, and about two thirds of Spanish women benefit from it when they give birth. However, these figures vary considerably from one hospital to another.
 
How does an epidural work?
An epidural blocks the nerves that reach the uterus or other body parts, depending on the level where you put. These nerve roots in a space surrounding the spinal cord, called epidural space. This is within the spine just outside the outer covering of the spinal cord.
Of interest
See our 'section Pregnancy and Childbirth 'other items related to childbirth:
  • The delivery (general)
  • Caesarean section
Doctor visits
Watch 'Ask the doctor' repondidas questions of our users.
How it gets an epidural?
Epidural always puts an anesthetist . The epidural space is located through a thin, hollow needle, usually in the lower part of the spine, and after application of a local anesthetic to the skin. Then insert a small space in the plastic tube through the needle and the needle is removed, leaving the tube in position. This tube is generally connected to an automatic infusion pump which is adjusted to continuously supply, until it stops required, a certain amount of local anesthetics and analgesics in the epidural space.
What are the side effects?
The most common are:
  • Fall in blood pressure: this occurs in most cases and is easily treated by administering serums and medication at the time. For this reason the patient's blood pressure is measured frequently while the epidural is administered.
  • Headache : also known as spinal headache happens to 1% of patients who received an epidural. It occurs when the needle goes through the dura (membrane that surrounds the spinal cord) and unintentionally passes to space where the spinal cord is housed. This is easily treated by the anesthetist.
  • There are special situations in which you should take extra care with epidural anesthesia, such as when there is a defective placenta.
Can all women have an epidural when in labor?
The use of epidural anesthesia has existed for many years, and it's a pretty safe and reliable technique. Yet it is not a risk-free practice and those patients that may arise use should receive a detailed and complete information so they can decide for themselves whether or not they want to benefit from this procedure.
some complications may occur, such as meningitis , because it occurred passage bacteria from the outside into the vertebral canal, but are rare unless appropriate measures are taken sterilization. There is also the risk of paralysis by damaging the nerve roots when lumbar epidural is administered, as the level at which it comes as no bone and, therefore, the paralysis is caused by the existence of abscess or hematoma.
There are some conditions that epidural anesthesia is not entirely advisable or may even be contraindicated, as some back problems. Neither it should be used when there is increased tendency to infections or bleeding, or where there are certain diseases of the nervous system. If any of these conditions occur should always be consulted in advance anesthesiologist.
Dr. Niels Lund , specialist in obstetrics and gynecology; Dr. Charlotte Floridon , general practitioner, Dr. FN Gordon Smith , a specialist in Anesthesiology

Traveling during pregnancy

The travel restrictions except short walks, was a common obstetric patients until World War II practice, when women were forced to take trips regardless of distance and how to travel.
From the data collected from this period, it has shown that for healthy women, the trips have no harmful effects on pregnancy.
Should we avoid travel?
In principle, the trips are not contraindicated during pregnancy as long as certain precautions are taken now indicate.
It is important to avoid travel to places where health resources are deficient, in anticipation of possible complications; also it will avoid long journeys to approach the target date for delivery.
 
Know more
See our section ' Pregnancy & Childbirth 'numerous items of interest:
  • Exercise during pregnancy
  • Diet during pregnancy
  • Dizziness during pregnancy
Doctor visits
Read many questions from our users at 'Ask the doctor'.
Basics that should be taken into account
  • Always travel with comfortable clothing that do not press him.
  • If the means of transport permits, stop every two hours to stretch your legs.
  • Do not take any medication for motion sickness without being prescribed by your doctor.
  • If you plan a trip in late pregnancy, talk to your gynecologist about the chances of a labor premature.
  • If you are not absolutely sure that the trip does not pose any risk to you, talk to your gynecologist.
Air Travel
Air travel is generally safe during pregnancy. Iberia, for example, forbids the trip to pregnant women during the last 15 days of pregnancy. The American Airlines allows travel up to 7 days before the due date, provided that the mother is well. Security detectors used by the security services are not hazardous to the health of the fetus.
When making air travel try to get a seat next to the halls or on the front; in this way it will be easier to stand and access to the toilet.
The relative humidity in aircraft cabins is kept only 8%, which promotes blood clots in the legs; To avoid this situation, try to walk every hour and drink plenty of liquids to improve hydration.
Boat trips
Boat trips are safe, although you should bear in mind, in the course of a trip at sea, the distance to a place where you may need medical assistance.
Before going on a boat trip, check with your gynecologist what kind of medication can be taken in case of suffering dizziness .
Train Travel
If planning a long journey by land, transfer by train to the bus is preferable, as it will provide greater freedom of movement.
Travel by car
Car travel for trips of short or medium distance are preferable to bus travel, since in the latter can not program stops freely.
  • Whenever you perform a drive, use the belts of security, because it is considered that the risk for both mother and fetus, is greater if not wearing a seatbelt.
  • The lower belt of the belt should be positioned on the lower portion of the stomach, as low as possible; if you could, on top of the thighs. The upper seat belt must pass between your breasts and across your shoulder without damaging the neck; Never slide the top of the belt outside his shoulder.
  • Do not put the belt around the abdomen, as this location can cause significant injury to the abdomen; Also, set the upper and lower belts as much as possible, for your convenience.
  • The main cause of fetal death in a car accident is the death of the mother.
Trips abroad
Before a trip abroad consult your doctor, who will advise you about the safety of travel and possible preventive measures to be taken. Do not take any medication without consulting your doctor. Sometimes it is prudent to delay the trip until after delivery.
In general, it is recommended to avoid travel to countries with poor sanitary systems or high altitude; Also during pregnancy is contraindicated, especially during the last quarter, the practice of scuba diving (can cause an oxygen deficiency in pregnant women).