International Journal of Obstetric Anesthesia

Papers
(The TQCC of International Journal of Obstetric Anesthesia is 0. The table below lists those papers that are above that threshold based on CrossRef citation counts [max. 250 papers]. The publications cover those that have been published in the past four years, i.e., from 2022-08-01 to 2026-08-01.)
ArticleCitations
P126 Ultrasound-assisted central neuraxial blockade in obstetrics- challenges and a quality improvement initiative: a DGH experience19
P147 Emergency general anaesthetic set up in delivery suite: a teamwork based approach18
P152 Preliminary findings from a post caesarean delivery pain core outcome set development study: is it time to shift our focus?18
P174 Successful MDT management of stress induced anaphylaxis complicating labour and delivery17
P6 Review of a post-natal anaesthetic clinic: addressing the physical and psychological impact of anaesthetic complications during childbirth16
P143 Programmed-intermittent epidural bolus regimen vs continuous epidural infusion: a retrospective, cohort study of motor block and obstetric outcomes16
P73 Recovery post-discharge following elective caesarean section16
P7 A retrospective analysis of the impact of ethnicity and preferred spoken language in obstetric anaesthesia15
P56 The use of lumbar epidural analgesia and anaesthesia for vaginal twin birth14
6248797 Spinal anaesthesia for Caesarean delivery in a patient with severe Factor VII deficiency14
P135 Obstetric admissions to intensive care in a district general hospital: a retrospective five-year review14
6299676 Prevalence and Risk Factors for Chronic Postsurgical Pain After Cesarean Section – A Prospective Study in A Tertiary Care Hospital of Bangladesh13
6275316 Supporting Parents and Professionals through neOnatal Resuscitation in Theatre – The SuPPORT Project13
6300197 Trauma Caesarean Section- an example of excellent interdisciplinary working12
6301395 Through the Anaesthetic lens: Managing challenges in a parturient with empty sella syndrome and idiopathic intracranial hypertension12
6268392 Can we keep the time on time? A survey of time keeping devices in a labour ward with synchronised digital wall clocks12
6270087 The ACORNS Course: Experiences from running a joint obstetrics and anaesthetics human factors simulation course12
6290519 Introduction of a safety huddle on delivery suite at St George's Hospital12
Over-exposed? Infrared thermography and the assessment of spinal anaesthesia11
Acute thrombocytopenia during cesarean section11
Felicity Reynolds (1935 – 2024)11
Effectiveness of artificial intelligence (AI) chatbots in providing labor epidural analgesia information: are we there yet?10
O.004 Maternal critical care follow-up: improving patient experiences and follow up10
Maternal exposure to general anesthesia and labor epidural analgesia during pregnancy and delivery, and subsequent neurodevelopmental outcomes in children10
P.158 Beyond the 4 T's – An unusual cause of major haemorrhage in the obstetric patient10
Maternal Enhanced and Critical Care (MEaCC) in Yorkshire and the Humber: regional implementation of an enhanced maternal care pathway and data collection10
P.120 Managing a traumatic unknown: A caesarean section in a women with potential ornithine transcarbamylase deficiency10
The importance of inclusion of neonatal outcomes in analysis of maternal peri-operative intravenous dexamethasone – reply to “Efficacy and safety of intravenous administration of dexamethasone on post10
Letter to the Editor: Mothers’ experiences of category 1 caesarean delivery under general anaesthesia with the partner present: a prospective explorative study9
Transient ischaemic attack and paradoxical embolism during caesarean delivery under spinal anaesthesia9
More than a spinal: the anaesthetist’s impact on safety, trust, and patient experience in planned caesarean birth9
Shivering during caesarean delivery: A narrative review with systematic methodology of incidence, mechanisms and management9
Improving equity and efficiency in labour epidural consent using QR codes: a quality improvement project9
The role of human factors in the decision to administer general anaesthesia for emergency caesarean deliveries: a qualitative interview study of anaesthesia trainees in Ireland9
Improving obstetric anaesthesia training with multidisciplinary maternal medicine simulation9
The utility of neutrophil-to-lymphocyte ratio in early detection of maternal sepsis: A retrospective observational study with a case-control design9
Alternating versus coadministration of multimodal non-opioid analgesia after cesarean delivery and pain outcomes: a single center quality improvement study (2024)8
In response to: “Obstetric anaesthesia in Japan–beyond provider identity to system design”8
Pregnancy revealing hereditary angioedema type III with factor XII mutation managed in a resource-limited setting with no C1-inhibitor concentrate availability: a case report8
6301178 Cauda Equina Syndrome in the third trimester of pregnancy, the importance of shared decision making8
Ethnic variations in the utilisation of remifentanil patient-controlled analgesia and epidural analgesia during labour8
Uterotonics in pregnant patients with cardiac disease: a focused review8
Gestational thrombocytopenia and risk of postpartum hemorrhage and severe maternal morbidity: a population-based analysis8
6275436 Decision making and mode of anaesthesia for category one caesarean sections: do anaesthetists and obstetricians share the same mental model?8
Measuring what matters in neuraxial labor analgesia quality improvement research: Prioritizing patient-reported outcomes8
A narrative review of the literature relevant to obstetric anesthesiologists: the 2023 Gerard W. Ostheimer lecture8
“Dexmedetomidine for cesarean delivery: clinical enthusiasm, limited evidence”: this Editorial should be a call to action8
Global issues in obstetric anaesthesia: perspectives from South Africa, Japan, China, Latin America and North America8
6268386 Heart to find?: A peripartum cardiomyopathy case series8
IJOA Supplement Editorial7
P155 Straight to theatre: should women with a high BMI be offered caesarean section routinely?7
P.028 How are sites across the UK escalating care during a postpartum haemorrhage?7
P140 An audit on indications for remifentanil PCA for labour analgesia leading to a quality improvement initiative: looking back to pay it forward7
P108 Enabling birth choices in theatre: how comfortable do staff really feel?7
6300686 Measuring service evaluation: a comparison of patient-reported time ready for discharge and length of stay as outcome measures after caesarean deliver7
P.014 Barrier precautions for obstetric spinal anaesthesia in the UK: An OAA national survey7
6301375 Emergency thoracotomy and caesarian section at 29 weeks gestation for suspected oesophageal rupture7
P95 Plasma exchange for HELLP syndrome complicated by persistent microangiopathic haemolytic anaemia resulting in a rapid recovery of renal function7
Author index7
P.063 An audit of critical care activity at the Rotunda Hospital Dublin in 20237
P.149 Promoting Maternal safety: Anaesthetists’ and Midwives’ perspectives on oral intake in labour and its impact on general anaesthesia for delivery6
P.076 Influence of dermal implants in the lumbar region on the consent process and technique for neuraxial placement: a survey of obstetric anaesthetists6
Editorial Board6
Cesarean section under spinal anesthesia in a first-time gravida with Fabry disease6
Neuraxial labor analgesia in type 2N von Willebrand disease: a case report6
Incorporating a postpartum hemorrhage bundle on the labor and delivery unit: a state-wide survey of anesthesiologists in Massachusetts6
P.135 Optimising successful intubation in obstetric patients with videolaryngoscopy6
P.068 Investigating analgesia adequacy and intraoperative pain during caesarean delivery: single-centre pilot and feasibility study6
Platelet parameters in preeclampsia: comparing rotational thromboelastometry and platelet aggregometry with standard laboratory tests6
Obstetric rapid sequence induction: a national survey of current practice6
P.177 Battle of the cannulations: Midwives v anaesthetists6
P.193 Anaesthetic management of parturient with Jarcho-Levin Syndrome for elective caesarean section6
Role of cosyntropin in the prevention of post-dural puncture headache: a propensity-matched retrospective analysis6
Artificial intelligence-created personal statements compared with applicant-written personal statements: a survey of obstetric anesthesia fellowship program directors in the United States6
Evaluating in-situ simulation accessibility and impact within maternity services6
Maternal intensive care during pregnancy and the risk of small for gestational age or preterm birth: a population-based Swedish cohort study5
Association between anaesthetic technique and postoperative pain following lower segment caesarean section for placenta accreta spectrum disorder5
Peripartum management of cardiac arrhythmias: a narrative review5
Anaesthetic challenges of caesarean delivery in a parturient with central airway obstruction5
Unique perioperative challenges in a parturient with cystic fibrosis and cystic fibrosis-related diabetes using a hybrid closed-loop insulin pump5
Pregnancy-associated fibrous epulis: a hidden cause of difficult intubation5
A case of Mirror Syndrome–distinct from pre-eclampsia?5
Discrimination, racism, and bias in childbirth pain management in the United States: a scoping review and directions for research and clinical care5
FLASH: fast learning across specialities about human factors. Five-minute flashcards for obstetric theatre teams: proof of concept trust wide QIP5
Gowns off for single shot obstetric spinal anaesthesia: a quality improvement project with an environmental focus5
Chronic pain and long-term disability following postdural puncture headache in obstetric patients: a five-year prospective follow-up of a case-control cohort5
In response to “Viscoelastic testing in postpartum obstetric hemorrhage: a scoping review commissioned by the Patient-Centered Outcomes Research Institute (PCORI)”5
P.214 When a patient's headache, becomes their anaesthetist's - An unusual case of post-instrumentation headache4
6301976 Service evaluation of current trends in rescue analgesia during Lower Segment Caesarean Sections under neuroaxial anaesthesia4
O.002 Are ‘care bundles’ sustainable? An evaluation of the OBS Cymru postpartum haemorrhage care bundle4
P.054 QI bundle for patient safety in Obstetric Genral Anaesthesia4
Fresh frozen plasma in postpartum hemorrhage: signal or severity?4
P.151 Method of anaesthetic antenatal review of women with morbid obesity: A national survey4
P157 Improving the safety and success of obstetric intubation with videolaryngoscopy: a quality improvement project in a tertiary obstetric unit4
Neuraxial anesthesia in obstetric patients with rare spinal pathologies: a scoping review4
Inadvertent epidural administration of tranexamic acid without neurological sequelae: a case report4
P.212 Doctor, I Can't Move My Arm! A Case of Temporary Upper Limb Monoparesis following Epidural Top-Up for Instrumental Delivery4
P.021 Lumbar ultrasound measurements are imprecise when compared with MRI: Is it more than tissue compression?4
P.130 A postpartum presentation of acute fatty liver disease of pregnancy4
O9 A prospective study of the effect of a ‘Sip ‘til Send’ fasting policy on patient reported and haemodynamic variables at elective caesarean delivery4
P75 Does the use of prilocaine for spinal anaesthesia improve recovery times compared to bupivacaine in women undergoing caesarean section?4
6301970 Rapid Sequence Induction in Obstetrics: a Survey of Practice across the North East and Cumbria4
P.088 Analgesia following caesarean delivery: Is it time to rationalise our use of opioids?4
Intraoperative dexamethasone and risk of postoperative infection after cesarean delivery: a retrospective cohort study4
P.118 Amniotic fluid embolism as a cause for maternal collapse4
O.008 Enhanced maternal care (EMC): a service evaluation from Yorkshire and Humber using the Maternal Enhanced and Critical Care (MEaCC) database4
Mothers’ experiences of category 1 caesarean delivery under general anaesthesia with the partner present: a prospective explorative study4
P8 Improving peri-operative anaesthesia for cervical cerclages: a quality improvement project4
P80 Maternal request caesarean delivery: understanding the impact on elective section list efficiency. What can we learn?4
6275602 Anesthetic management of a pregnant patient with congenital long QT syndrome type 2 undergoing ovarian dermoid cyst excision: A Case Report4
Neuraxial labor analgesia in a pregnant patient with cystic hygroma and aberrant neurovasculature: a case report4
Acute fatty liver of pregnancy complicated by multiorgan failure requiring renal replacement therapy: a multidisciplinary case report3
P131 Perioperative outcomes in surgical patients with preeclampsia3
Assessing the accuracy and quality of TikTok as a source of medical information on neuraxial labor analgesia: a cross-sectional study3
O2 Observational study of peripheral skin temperature changes following spinal anaesthesia for caesarean delivery3
P188 Combined spinal epidural anaesthesia for caesarean section in a parturient with dilated cardiomyopathy3
6301612 An Audit of Regional Analgesia in Labour – Can Standards Be Met for Obese Patients?3
P48 Intrapartum blood glucose monitoring: are we meeting the national standard?3
6288138 Blindsided by unusual pre-eclampsia complication3
Inclusion of block efficacy in the WHO surgical safety checklist for maternity patients: a case for enhanced safety and patient-centred care3
P70 Assessment of neuraxial block and management of intraoperative pain in obstetrics3
P115 An evaluation of anaesthesia for abnormally invasive placenta utilising interventional radiology3
“This is how we do it” Anaesthesia for uterine transplant and associated surgeries: the Australian-Swedish collaborative protocol3
Epidural-related maternal fever and metabolomic changes: a pilot exploratory study3
Cardiac arrest in a pregnant patient caused by coronary artery vasospasm due to ergometrine3
Stick with the epidural blood patchor consider fibrin glue for management of postdural puncture headache?3
In response to Ogawa et al on editorial “Obstetric anesthesia in Japan: An existential crisis in need of an intervention”3
Intrathecal fentanyl and intraoperative pain during fetoscopic laser photocoagulation: a single-center retrospective cohort study (2020–2025)3
Pain during cesarean delivery: tools for doing better3
Prolonged neurological block following epidural anaesthesia: a functional diagnosis of exclusion3
A ’topic of the week’ quality improvement intervention to enhance formal teaching during obstetric anaesthesia placements3
P118 A survey of postnatal venous thromboembolism prophylaxis3
6290035 An approach to prevention and treatment of hypotension in elective caesarean sections under spinal anaesthesia: A survey from a developing nation3
P25 Assessing accuracy of visual estimation of blood loss during simulated postpartum haemorrhage scenarios3
P121 Improving antenatal information on pain management in labour and delivery3
6300110 Equity in pain management in labour: a service evaluation3
P.188 Suprapannicular Caesarean Section- is a thoracic epidural really necessary?3
6300082 A service evaluation on regional anaesthetic block testing for caesarean section3
P164 Combined spinal epidural anaesthesia for caesarean section for a parturient with moyamoya disease and sickle cell disease3
Editorial Board3
Aspiration risk assessment for postpartum tubal ligation using gastric ultrasound: a single-center prospective observational trial3
Evaluation of red blood cell transfusion, intraoperative cell salvage and fibrinogen replacement in placenta accreta spectrum disorder3
Postpartum bilateral lower-extremity palsy after labor epidural analgesia associated with a spinal epidermoid cyst: a case report3
Improving documentation in an obstetric high dependency unit3
Anaesthetic management of obstetric patients with Chiari 1 malformation with or without syringomyelia: a multidisciplinary consensus statement from the Obstetric Anaesthetists’ Association (OAA)3
Simulation-based training in obstetric anesthesia: an update3
P134 Obstetric admissions to the intensive care unit in Malta over a six-year period (2016–2021)3
Surveying local guidance for management of accidental dural puncture and subsequent augmentation with a decision aid flowchart to improve confidence3
Empowering patients through video: enhancing the labour epidural consent experience3
Persistent opioid use after cesarean delivery in the United States of America: a systematic review3
P34 Ultrasound guided neuraxial anaesthesia: a quality improvement project to improve anaesthetist competence and confidence scanning the lumbar spine3
P150 Availability of total intravenous anaesthesia for pregnant people: a survey of UK practice3
P1 Reducing rates of antenatal anaemia: utilising serum ferritin as an early marker of iron deficiency3
P38 Assessing the impact of intensive positive feedback on staff morale, culture, civility and psychological safety in a South West maternity unit3
6302079 Let's Talk Epidurals: Tea Trolley Training for Midwives3
Improving blood product management in placenta accreta patients with severe bleeding: institutional experience3
6274094 An audit of obstetric admissions to a high dependency unit, in a tertiary maternity hospital3
Virtual reality compared to nitrous oxide for labor analgesia: a feasibility pilot, prospective, randomized, cross-over, non-inferiority study3
6301584 Assessing the multimodal analgesia approach post caesarean section: diamorphine versus fentanyl and morphine for neuraxial analgesia3
Comparative efficacy of quadratus lumborum type-II and erector spinae plane block in patients undergoing caesarean section under spinal anaesthesia: a randomised controlled trial3
Making simulation stick: overcoming barriers to ward-based MDT simulation in a busy tertiary maternity unit3
Evaluating tabtracker: a mobile app for medication self-administration post caesarean section3
Beyond technical excellence: the human dimensions involved in general anesthesia for emergency cesarean delivery3
Labour: a pain for informed consent?3
Is the erector spinae plane block a solution for sacral sparing during neuraxial labor analgesia?3
P9 Measuring the distance to the epidural space in women of childbearing age: preliminary results from a retrospective MRI study3
6292830 Multidisciplinary team training is not just simulation … Anaesthetic trainee knowledge and understanding of Cardiotocography (CTG)2
Optimising analgesia after caesarean birth: a retrospective audit2
P.017 A national survey of the availability of Clauss fibrinogen testing in obstetric units across the UK2
To gown or not to gown... that is the question!2
Serotonin syndrome following spinal anaesthesia for elective caesarean delivery: a case report2
Improving recognition of delayed motor recovery after obstetric neuraxial anaesthesia using a timed straight-leg raise wristband2
Remimazolam administration for severe anxiety during a neuraxial block placement in active labor2
Effect of prophylactic intravenous calcium gluconate on uterine atony during intrapartum cesarean delivery with spinal anesthesia: a placebo controlled, randomized clinical trial2
Anesthetic management for emergency cesarean section in a patient with Townes-Brocks syndrome2
P21 FIBTEM A5 correlates well with laboratory Clauss fibrinogen results in the obstetric population2
P.086 Remifentanil for management of intra-operative discomfort during LSCS under neuraxial anaesthesia2
P16 Improving documentation in obstetric anaesthesia2
P24 Impact of focusing definitions of postpartum haemorrhage2
P.205 Cardiac complications in a pregnant patient with rheumatic valve disease: a cautionary tale2
Anaesthetic considerations for impacted fetal head at caesarean delivery: a focused review2
P.024 Optimising Postpartum Haemorrhage (PPH) Management at a High Risk Obstetric Centre: A Multidisciplinary Approach to embed OBSCymru principles2
Double emergency during elective lower uterine segment caesarean section2
Bilateral erector spinae plane catheters for labor analgesia in the setting of idiopathic thrombocytopenia purpura2
6302087 A severe case of puerperal sepsis related AKI2
P.191 Anaesthetic management for caesarean section for parturient with SOX-11 genetic mutation2
A QR code based multimodal education pathway to support consent and positioning for neuraxial anaesthesia in obstetrics2
Anesthesiology resident preferences regarding learning to perform epidural anesthesia procedures in obstetrics: a qualitative phenomenological study2
P151 Factors associated with general anaesthesia in elective caesarean section2
Evaluation of the relationship between the Obstetric Comorbidity Index (Ob-CMI) and the Obstetric Quality Of Recovery Score (ObsQoR-11): a prospective observational study2
Does parity alone explain intrathecal ropivacaine requirements for labor analgesia? In response to “Median effective dose (ED50) of intrathecal ropivacaine for labor analgesia initiation in nulliparou2
Obstetric anesthesia in Japan: an existential crisis in need of an intervention2
P160 Understanding patient experience of elective caesarean section: an exploratory mixed method study utilising patient shadowing2
P.102 Management of caesarean birth in patient with congenital inferior vena cava agenesis2
A novel device for sealing dural perforation via an epidural needle: an in vitro evaluation of effectiveness2
Treat first, deliver second: management of aneurysmal subarachnoid haemorrhage in late pregnancy2
Scholarship in anesthesiology: the role of critical appraisal, literature review, quality improvement, journal club, and presentation skills2
P.019 An audit of postpartum neuropathies in The National Maternity Hospital, Dublin2
Postpartum sleep quality and physical activity profiles following elective cesarean delivery: a longitudinal prospective cohort pilot study utilizing a wearable actigraphy device2
6301325 A “CSE-ries” of questions. Current practice in combined spinal epidural anaesthesia for caesarean delivery across two large obstetric units2
6301733 The impact of mental health problems on medical comorbidity in pregnancy: a case of overt hypothyroidism2
Use of high-flow nasal oxygen for pregnant women with COVID-19 in the labour ward setting2
6301939 Mitigation of Entonox emissions, a quality improvement project2
P.059 Survey on Anaesthesia for Cervical Cerclage2
Large language models for overcoming language barriers in obstetric anaesthesia: a structured assessment2
Mechanical circulatory support for maternal cardiac arrest secondary to high neuraxial block in a patient with class three obesity: a case report2
Erector spinae plane block for acute renal colic in a pregnant patient2
Editorial Board2
P145 Epidural top-up rates of obesity class three patients at Grange University Hospital2
General anaesthesia for caesarean delivery in women with class 3 obesity: case series from nine hospitals across the north-west of England (2022–2023)2
P90 Management of a parturient with a “filamin-A mutation”2
Quantitative blood loss after vaginal delivery: a retrospective analysis of 104 079 measurements at 41 institutions2
Acute colonic pseudo-obstruction and ileus following caesarean section: a three-year service evaluation2
Early initiation of skin to skin contact during caesarean birth: a quality improvement project2
P.183 A case of misunderstanding: clinical decision-making bias in a patient presenting with acute kidney injury and deranged liver function tests2
Assessing behavioural influences and behavioural changes following Safer Anaesthesia From Education (SAFE) Obstetrics training in Africa and Asia2
6301355 Implementation of a maternity hospital ROTEM guided transfusion strategy- economic and clinical impact: A pre-post retrospective cohort study2
6300042 Massive goitre causing severe tracheal stenosis in pregnancy2
Total intravenous anaesthesia for caesarean delivery: incidence, maternal and neonatal outcomes from a tertiary unit2
Alertive - communication tool or verb? A survey of maternity service clinicians before and after introduction of a replacement ‘bleep’ system1
Labor epidural analgesia among Han and Uyghur parturients: a prospective observational study in China1
In response to “Maternal physiological parameters and routine laboratory tests to screen for maternal sepsis: an observational cohort study” - Neutrophil-to-lymphocyte ratio as a promising cost-effect1
6287016 The physiological changes in pregnancy, a hazard?1
Prophylactic phenylephrine infusion versus treatment with vasopressor bolus as needed during non-urgent cesarean delivery and neonatal acidemia: a retrospective cohort study (2016–2021)1
6301857 A model-based cost-effectiveness analysis of epidural blood patching versus conservative management in the treatment of post dural puncture headache1
P.100 Learning points from a case of peripartum takotsubo cardiomyopathy for the obstetric anaesthetist1
P.155 Critical care admission data for obstetric haemorrhage; a tertiary centre retrospective analysis1
Anaesthetic management of obstetric patients with Chiari type I malformation: a retrospective case series and literature review1
Patient-reported postoperative pain and stigmatizing language in anesthesia notes: a cross-sectional study (2017–2019)1
Awareness, perceptions, and desirability of epidural analgesia among pregnant women at a remote hospital in Sri Lanka1
Quality of recovery after cesarean delivery in patients with Class III obesity: a prospective observational cohort study1
P.215 Anaesthetic management For Cesarean Section in Paraplegic patient with kyphoscoliosis and Autonomic dysreflexia1
Optimising anaesthetic care for the morbidly obese parturient: recommendations from a single-centre service evaluation1
6299574 Post-spinal headache as a risk for post-spinal headache: are we telling patients the truth?!1
P.210 Severe Neurological Complications in Pregnancy: A Case of ADEM1
P.192 Anesthetic management of a pregnant patient with carcinoid tumor undergoing cesarean delivery1
P.057 “Desperate to understand what happened”: exploring experiences of maternal critical care1
Obstetric hemorrhage risk assessment using the maximum allowable blood loss calculation: are we on the right track?1
Postpartum neurological deficits following neuraxial intervention: a retrospective analysis in a tertiary obstetric centre (2021-2023)1
Erratum to “A randomized trial to investigate needle redirections/re-insertions using a handheld ultrasound device versus traditional palpation for spinal anesthesia in obese women undergoing cesarean1
Anaesthetic management of a pregnant woman with super obesity and complex co-morbidities undergoing caesarean section delivery1
A quality improvement project to create an epidural troubleshooting guideline for midwives1
A comparison between PIEB/PCEA and midwife-delivered epidural bolus for labour analgesia on patient satisfaction, mobility and staff workload1
Mechanical circulatory support as a bridge to delivery in a pregnant patient with dilated cardiomyopathy and acute heart failure: a case report1
P.013 Trends in social media use amongst parturients and maternity staff: A UK survey1
P.208 Case report of a parturient with a cerebellar hemangioblastoma and acute hydrocephalus related to Von Hippel-Lindau disease1
P.069 Obstetric patients on hybrid closed loop systems during labour and birth: a retrospective cohort study1
Ten plus ten equals twenty: a prospective crossover study evaluating syringe size and speed of epidural injection1
Terminology for abnormally invasive placenta: still confusing1
Factors associated with severe pain during the active phase of pushing despite labor epidural analgesia: a secondary analysis on a prospective cohort study1
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