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The use of lumbar epidural analgesia during the first stage of labour in high-risk pregnancies


W.H. Mercer
E.G. Simons
R.H. Philpott

Abstract

The high-risk pregnancy is presented as a priority indication for epidural analgesia during labour. This would include cardiac disease, inefficient uterine action, with or without cephalopelvic disproportion, certain cases of antepartum haemorrhage, multiple pregnancy, breech presentation, pre-eclamptic toxaemia and all causes of suspected placental insufficiency. The intensive care necessary for the management of these patients is simplified when an epidural block is used and the built-in anaesthesia permits immediate recourse to operative interference when indicated. To ensure safety for mother and fetus, the importance of limiting this procedure to the hands of those who have received supervised training and proved their skill, and the need for meticulous attention to detail, are stressed.

S. Afr. Med. J. o 48, 774 (1974).

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eISSN: 2078-5135
print ISSN: 0256-9574