BJOG An International Journal of Obstetrics & Gynaecology · 1974 · 38 citations · 2 references
MedicineAnesthesiologyObstetricsAnesthesiaAnesthetic TechniquesObstetric AnesthesiaEpidural AnesthesiaNeonatal AnesthesiaObstetric Regional AnesthesiaAnalgesia In ParturitionBreech Extraction ComplicationsEpidural Analgesia In ObstetricsLumbar Epidural AnesthesiaSpinal Anesthesia In NeonatesSpinal Anesthesia In ObstetricsTotal Breech Extraction
Summary A consecutive series of 247 patients with a singleton fetus presenting by the breech (exclusive of instances of macerated stillbirth and of lethal congenital abnormality) is presented. The series includes 162 patients who had a vaginal delivery, lumbar epidural block analgesia having been provided for 56 of those. Examination of the “Apgar‐minus‐colour” scores and of the postnatal course of these infants strongly suggests that the provision of an epidural block reduces the incidence of Severe and of prolonged neonatal depression irrespective of the birthweight. The incidence of breech extraction was not increased by the provision of an epidural block, although the second stage was significantly (but not markedly) lengthened. It is suggested that a reduction in the morbidity and mortality associated with vaginal breech delivery could be attained by the provision of a regional block (epidural or spinal) which will obtund the bearing‐down reflex and relax the perineum.
2