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Monitoring pudendal nerve function during labor
1Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Indiana University/Methodist Hospital, Indianapolis, USA. mattclark44@yahoo.com
Obstetrics and Gynecology
|April 11, 2001
Summary
Pudendal nerve monitoring during labor is feasible using transvaginal stimulation. Continuous wire stimulation proved difficult and offered no additional benefits over intermittent methods for assessing nerve function.
Area of Science:
- Neurology
- Obstetrics
- Physiology
Background:
- Pudendal nerve monitoring during labor and delivery requires evaluation for methodology and feasibility.
- Assessing intrapartum pudendal nerve function is crucial for understanding potential nerve-related complications during childbirth.
Purpose of the Study:
- To determine the methodology and feasibility of monitoring the pudendal nerve during labor and delivery.
- To compare continuous wire stimulation with transvaginal intermittent stimulation for pudendal nerve assessment.
Main Methods:
- 13 low-risk pregnant women underwent pudendal nerve compound muscle action potential recording during labor and postpartum.
- Transvaginal St. Mark's electrode stimulation was used for 11 patients, with urethral sphincter monitoring via a Foley catheter.
- Continuous wire stimulation was initially trialed on two patients.
Main Results:
- Intrapartum assessment of pudendal nerve function was found to be feasible.
- Continuous wire stimulation presented technical difficulties and was easily dislodged.
- Transvaginal stimulation yielded interpretable data in 11 patients, with 53 out of 85 potential potentials recorded.
Conclusions:
- Intrapartum pudendal nerve function assessment is feasible.
- Transvaginal intermittent stimulation is a viable method for monitoring pudendal nerve function during labor.
- Continuous wire stimulation is technically challenging and does not offer advantages over intermittent stimulation.