{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:12:12Z","timestamp":1777666332310,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["DoelmatigheidsOnderzoek"],"award-info":[{"award-number":["DoelmatigheidsOnderzoek"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the association between epidural analgesia (EDA) <jats:italic>vs<\/jats:italic> patient\u2010controlled remifentanil analgesia (PCRA) and emergency delivery for presumed fetal compromise, in relation to birth\u2010weight quintile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a <jats:italic>post\u2010hoc<\/jats:italic> per\u2010protocol analysis of the RAVEL multicenter equivalence randomized controlled trial. Non\u2010anomalous singleton pregnancies between 36\u2009+\u20090 and 42\u2009+\u20096\u2009weeks' gestation were randomized at the time of requesting pain relief to receive EDA or PCRA. The primary outcome was emergency delivery for presumed fetal compromise. Secondary outcomes included mode of delivery and neonatal outcomes. Analysis was performed according to birth\u2010weight quintile and was corrected for relevant confounding variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 619 pregnant women, 336 received PCRA and 283 received EDA. Among women receiving EDA, 14.8% had an emergency delivery for presumed fetal compromise, compared with 8.3% of women who received PCRA. After adjusting for parity, women receiving EDA had higher odds of presumed fetal compromise compared to those receiving PCRA (odds ratio, 1.69 (95%\u00a0CI, 1.01\u20132.83)). A statistically significant linear\u2010by\u2010linear association was observed between presumed fetal compromise and birth\u2010weight quintile (<jats:italic>P<\/jats:italic>\u2009=\u20090.003). The incidence of emergency delivery for presumed fetal compromise was highest in women receiving EDA and delivering a neonate with a birth weight in the lowest quintile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intrapartum EDA is associated with a higher rate of emergency delivery for presumed fetal compromise compared to treatment with PCRA. Birth\u2010weight quintile is a strong predictor of this outcome, independent of pain management method. \u00a9 2023 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26308","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T06:24:45Z","timestamp":1689315885000},"page":"675-680","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Epidural analgesia and emergency delivery for presumed fetal compromise: <i>post\u2010hoc<\/i> analysis of <scp>RAVEL<\/scp> multicenter randomized controlled trial"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2159-7700","authenticated-orcid":false,"given":"E. S. E.","family":"Tabern\u00e9e Heijtmeijer","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Groen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. E.","family":"Damhuis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"},{"name":"Department of Obstetrics and Gynecology Amsterdam University Medical Centers, University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. M.","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"Middeldorp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ikazia Hospital  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Ganzevoort","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam University Medical Centers, University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3915-8609","authenticated-orcid":false,"given":"S. J.","family":"Gordijn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"77","article-title":"Women's experience of pain during childbirth","volume":"15","author":"Beigi NMA","year":"2010","journal-title":"Iran J Nurs Midwifery Res"},{"key":"e_1_2_8_3_1","article-title":"Epidural versus non\u2010epidural or no analgesia for pain management in labour","volume":"5","author":"Anim\u2010Somuah M","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_4_1","unstructured":"WHO recommendations: intrapartum care for a positive childbirth experience.2018.https:\/\/www.who.int\/publications\/i\/item\/9789241550215."},{"key":"e_1_2_8_5_1","article-title":"Perinatale zorg in Nederland anno 2008: Landelijke perinatale cijfers en duiding","author":"Perined","year":"2008","journal-title":"Utrecht"},{"key":"e_1_2_8_6_1","article-title":"Perinatale zorg in Nederland anno 2020: Duiding door landelijke perinatale audit en registratie","author":"Perined","year":"2021","journal-title":"Utrecht"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26309"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000576"},{"key":"e_1_2_8_9_1","first-page":"139","article-title":"Advances in labor analgesia","volume":"1","author":"Wong CA","year":"2010","journal-title":"Int J Womens Health"},{"key":"e_1_2_8_10_1","first-page":"1785","article-title":"Epidural analgesia during labor","volume":"58","author":"Vincent RD","year":"1998","journal-title":"Am Fam Physician"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h846"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-12-63"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005025"},{"issue":"383","key":"e_1_2_8_14_1","first-page":"e1","article-title":"From population reference to national standard: new and improved birthweight charts","volume":"220","author":"Hoftiezer L","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.08.009"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2007.09.003"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000448949"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2010.10.012"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2020.05.024"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26308","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T07:53:40Z","timestamp":1699602820000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.26308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1002\/uog.26308"],"URL":"https:\/\/doi.org\/10.1002\/uog.26308","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]},"assertion":[{"value":"2023-04-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}