This document summarizes considerations for epidural analgesia in labor and delivery. It discusses risks and complications of epidurals including mortality rates, contraindications, potential maternal complications, and methods for treating complications like spinal headaches. It also addresses coagulation concerns, appropriate analgesia for conditions like preeclampsia, techniques for epidural administration, and outcomes including pain relief rates and complication rates.

1. EPIDURAL ANALGESIA IN LABOR

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4. Mortality crude overall mortality 1:1000 operations death during anesthesia or within 24hrs 1:13000 complications 1:750 anesthetics death due to anesthesia 1:250000

6. Steps of Epidural Injection

14. Coagulation Disorders in Pregnancy Physiological Changes Coagulopathies in Pre-eclampsia Iatrogenic coagulation disorders Diseases associated with coagulation abnormalities

16. ASPIRIN LOW-MOLECULAR- WEIGHT HEPARIN or a COMBINATION OF THEM To do or not to do EPIDURALS ???

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23. Analgesia Satisfaction Rate Satisfactory pain relief 91% Incomplete analgesia 4% Unilateral analgesia 3% Without any pain relief 2%

27. Thank You !!! תודה !!!