Anesthesia techniques: 1st stage labor

Obstetric Anesthesia

Stage I:

  • Variable duration
  • Starts at onset of labor
  • Complete when the rate of cervical dilation increases (~ 3 cm)
  • acceleration phase
  • phase of maximal slope
  • deceleration phase

Normal active labor should progress 1 cm/hr Most common measure of uterine activity is the Montevideo unit (avg intensity frequency per 10 minutes)

Stage II : interval between maximal dilation and delivery (20-120 mins)

Stage III : placental delivery (5-20 mins)

In the first stage of labor, pain travels via sympathetic nerve fibers (going through the inferior hypogastric plexus on the way to the sympathetic chain) that originate from the T10-L1 segments of the spinal cord (referred to the back as well as abdominal wall).

Common techniques include systemic medication administration (single doses of < 1 ucg/kg or lower appear to have no effects on fetal APGAR scores).

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2010

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