special populations epidural analgesia

what happens during the first stage of labor

dilation of cervix and distention of lower uterine segment

dull, aching, poorly localized pain

what kind of nerves are activated in the first stage of labor

slow conducting visceral C fibers

where do the nerve fibers that are activated during the first stage of labor enter the spinal cord 

T10-L1 

what happens during the second stage of labor

distention of the pelvic floor, vaginal canal, and perineurium

sharp severe and well localized pain

what kind of nerves are activated in the second stage of labor 

rapidly conductin A delta fibers 

what kind of sensation is felt by A delta fibers 

sharp severe well localized pain 

where do the nerves that are activated in the second stage of labor enter the spinal cord

S2-S4

what are the indications for a labor epidural analgesia

pain experienced by woman in labor

when medically benefitted to reduce the stress of labor

where is the general area of numbness with an epidural

top of uterus (diaphragm) down

what are effects of inducing and epidurals 

strong constant contractions

possible decreased O2 to baby 

increased pain 

inability to walk or stand

prolong labor 

ineffective pushing 

increase risk of instrument assisted and C-section delivery 

what are postpartum complications of epidurals

increase spinal headache

long term back pain

cardiac arrest

local anesthesia toxicity

what is the main purpose of a labor epidural analgesic

numb pain from waist down