BACKGROUND: Pudendal nerve block is one of the many methods of providing analgesia during the second stage of labor. This study was conducted in a university based tertiary hospital. The efficacy of pudendal nerve block was compared to low spinal anesthesia in patients who delivered vaginally METHODS: Thirty four parturients randomly received either pudendal nerve block (n=17) or low spinal anesthesia (n=17) during the second stage of labor. Those requiring analgesia during the first stage of labor were given a single shot epidural dose using bupivacaine 0.125 percent. No intravenous sedatives or analgesics were given throughout labor and delivery. Pain scores using a visual analog scale of 0.10 were recorded as well as the mean onset, mean duration and mean Apgar scores of the two groups. Complications of either technique were also noted down RESULTS: In pudendal nerve block, the mean pain score was 4.88 compared to 0 (zero) in spinal anesthesia. The pudendal group showed a longer onset, shorter duration of analgesia than the spinal group. The only complications noted were mild hypotension (11.7 percent) and minimal motor block (29.4 percent) seen in the spinal group. The mean Apgar scores of the two groups were greater than 7 and was not significantly different CONCLUSION: Pudendal nerve block is a simple and safe method of providing analgesia. The significant reduction of the pain score to more than half may imply a reduction in the amount of intravenous analgesics and potent sedatives often employed during labor and delivery. (Author)
Human ; Female ; ANESTHESIA, SPINAL ; VAGINAL DELIVERY ; ANALGESIA ; LABOR STAGE, SECOND ; OBSTETRIC DELIVERY

OBJECTIVES: To understand the prevalence of postpartum morbidities and factors associated with treatment-seeking behaviour among currently married women aged 15-49 residing in rural India. METHODS: We used data from the nationally representative District Level Household Survey from 2007-2008. Cross-tabulation was used to understand the differentials for the prevalence of postpartum morbidities and treatment-seeking behaviours across selected background characteristics. Two-level binary logistic regression was applied to understand the factors associated with treatment-seeking behaviour. RESULTS: Approximately 39.8% of rural women suffered from at least one of the six postpartum morbidities including high fever, lower abdominal pain, foul-smelling vaginal discharge, excessive bleeding, convulsions, and severe headache. Morbidities were more prevalent among poor, illiterate, Muslim, and high-parity women. About 55.1% of these rural women sought treatment/consultation for their problems. The odds of seeking treatment/consultation increased as economic status and years of schooling among both the woman and her husband increased. Poor, uneducated, unemployed, Hindu, and tribal women were less likely to seek treatment/consultation for postpartum morbidities than their counterparts were. The odds of seeking treatment/consultation decreased as the distance to the nearest private health facility increased. Most women visited a private hospital (46.3%) or a friend/family member's home (20.8%) for treatment/consultation. Only a small percentage visited publicly funded health institutions such as a primary health centre (8.8%), community health centre (6.5%), health sub-centre (2.8%), or district hospital (13.1%). Rural women from the northeast region of India were 50% less likely to seek treatment/consultation than women from the central region were. CONCLUSIONS: Providing antenatal and delivery care, and ensuring nearby government healthcare facilities are available to serve rural women might increase the likelihood of care-seeking for postpartum morbidities. Targeted interventions for vulnerable groups should be considered in future policies to increase the likelihood women will seek treatment or advice postpartum.
Abdominal Pain ; Delivery of Health Care ; Family Characteristics ; Family Conflict ; Female ; Fever ; Financial Management ; Headache ; Health Facilities ; Hemorrhage ; Hospitals, District ; Hospitals, Private ; Humans ; India* ; Islam ; Logistic Models ; Postpartum Period* ; Prevalence ; Seizures ; Spouses ; Vaginal Discharge