Spinal anesthesia is dangerous for pregnant women

PDA at birth

What is a PDA birth?

The PDA is an anesthetic method that is often used during childbirth to alleviate the pain that women experience, which are often very intense. To do this, the doctor injects a medication near the spinal cord and thus suppresses the transmission of signals from the nerves for a certain period of time. With the correct dosage, the patients are pain-free, but can still continue to press.

When is an epidural used in childbirth?

A PDA birth is usually carried out at the request of the pregnant woman. In addition, there are other reasons for using a PDA at birth:

  • High-risk births, for example if you have high blood pressure during pregnancy
  • severe pain with a previous birth without an epidural
  • Pregnancy with twins or triplets
  • certain misalignments of the child in the birth canal
  • expected operations during childbirth, such as perineal incision
  • Maternal illnesses, for example diabetes

Epidural anesthesia is also used for a caesarean section. However, if the operation is urgent, the doctor usually decides on spinal anesthesia. This procedure is very similar to the PDA, but works faster and more reliably.

What do you do when giving birth to a PDA?

With a PDA, certain spinal cord nerves are anesthetized. To do this, the doctor uses a special needle to pierce the locally anesthetized skin between two vertebral bodies in the lumbar spine area. The pregnant woman usually lies on her left side because in this position the child does not press on the large blood vessels in the mother's abdomen.

Now he leads the needle up to the firm skin that envelops the spinal cord (dura mater). He pushes a thin plastic tube into this so-called epidural space, through which the pain reliever medication (anesthetic) is injected. An automatic syringe pump ensures a constant effective level of the anesthetics. The patient now only feels a feeling of pressure, but no more pain.

What are the risks of a PDA birth?

Common complications when using an epidural are headache, nausea, and dizziness. These are based on accidental damage to the meninges (post-puncture syndrome). If the doctor injects too little medication into the epidural space, this may lead to inadequate pain relief or, in the case of an overdose, to paralysis of the muscles during childbirth. Incorrect PDA settings can also lead to disruptions in labor.

In the area of ​​the puncture site, despite careful disinfection, introduced bacteria can cause an encapsulated accumulation of pus (abscess) that compresses the spinal cord and causes pain. The patient may also be allergic to the drugs used. A very rare but dangerous complication is the accidental injection of local anesthetics into a blood vessel. This can lead to seizures and serious cardiac arrhythmias.

There is usually no danger for the child during a PDA birth: breathing and heartbeat are hardly affected by the medication used.

What should I watch out for after having a PDA?

After giving birth to an epidural, it is imperative that you contact your doctor if your pain gets worse or if you feel nausea, shortness of breath or chest pain. Rapid clarification of the cause is also important in the case of abnormal sensations, muscle cramps or back pain radiating into the legs.

Since the muscle coordination of the trunk and legs is still restricted for a while after the birth due to the anesthesia, you should do this after one PDA birth only get up under supervision to avoid falling.

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