الفهرس Only 14 pages are availabe for public view
 |  | from | 127 |  |  |
| | | from | 127 | | |
Abstract
Labour is defined as regular painful contractions of the uterus with cervical effacement and dilatation which results in expulsion of the foetus after 28 weeks of pregnancy. It is associated with severe pain for most of the women, this results in release of catecholamines which affect harmfully both mother and foetus (Thorp et al., 1993). Painful labour can affect maternal psychological attitudes, the course of labour, and the state of newborn child; therfore, adequate analgesia during labour is an essential part of modern obstetrics (Prichard et al., 1985).
Despite the increasing use of epidural and intrathecal analgesia during the stages of labour, most women depend on systemic analgesics. This is because the administration of systemic analgesia is a simple, safe, effective method of obstetric analgesia, and suitable to be carried out by midwives, and junior obstetricians as well as anaesthesiologists with no need for advanced training in anaesthesia (Pearson and Davies, 1974). Besides, systemic analgesia is claimed to be the most effective method for reducing the emotional stress of fear and anxiety accompanied with labour process (Morgan et al., 1984).
Pethidine; a narcotic analgesic remains the standard analgesic drug for obstetrics. Intramuscular (IM) or intravenous (IV) injections always give useful pain relief and more likely cause unpleasant side-effects in the mother; nausea, vomiting, hypotension, myocardial and ventilatory depression, seizures, and urinary retention (Stoelting, 1999). The placental transfer of pethidine is extensive, foetal blood levels averaging 70% of those in maternal blood. Pethedine reduces beat-to-beat variability in the foetal heart rate (Petrie et al., 1978). Neonatal respiratory depression, and depressed neurobehavioral responses that persist for up to 48 hours after birth in infants whose mothers have received pethidine, should be reversed by narcotic antagonist (Wiener et al., 1977).