medicación recomendada para la sedación intraparto con dolantina, valium,

Recommended Medication for Intrapartum Sedation with Dolantina (Diazepam), Valium (Diazepam), or Combination:

• Diazepam (Valium) and equivalent benzodiazepines such as Dolantina are generally not recommended for intrapartum sedation due to safety concerns during pregnancy and especially during labour because of potential adverse neonatal effects including hypothermia, hypotonia ("Floppy Infant Syndrome"), heart rate irregularities, poor suckling, and respiratory depression if given in high doses late in pregnancy or during labour. This is particularly pertinent when administered during the first and third trimesters of pregnancy. SmPC Diazepam,SmPC Diazepam,SmPC Diazepam,SmPC Diazepam
• Use of diazepam during labour at high doses may also result in neonatal physical dependency with a risk of withdrawal symptoms postnatally. SmPC Diazepam,SmPC Diazepam,SmPC Diazepam,SmPC Diazepam
• The risk of congenital malformations, particularly oral clefts, may be slightly increased if benzodiazepines are taken during the first trimester, though a causal link has not been conclusively established. SmPC Diazepam,SmPC Diazepam,SmPC Diazepam
• The available guidelines and summaries of product characteristics strongly advise caution and generally contraindicate use of diazepam during pregnancy and advise it should only be used if compelling medical reasons exist. Particularly, its use is not advised during labour unless no alternatives are suitable. SmPC Diazepam,SmPC Diazepam,SmPC Diazepam,SmPC Diazepam
• If benzodiazepines such as diazepam are considered necessary in a woman of childbearing potential or during pregnancy, the patient should be advised to contact her physician promptly if pregnancy is suspected or planned. SmPC Diazepam,SmPC Diazepam,SmPC Diazepam,SmPC Diazepam
• The safety of combining diazepam with other sedative agents intrapartum is not supported by specific guideline data and would carry similar cautionary considerations.

General Guidelines and Precautions for Intrapartum Sedation:

• The NICE guideline NG235 on intrapartum care emphasizes the availability of safer analgesia options such as Entonox (nitrous oxide with oxygen), opioid analgesics like pethidine and diamorphine, and remifentanil PCA with strict monitoring precautions. NICE NG235
• Use of opioids intrapartum should be accompanied by antiemetics, and there are cautions related to motor side effects on both mother and baby, including neonatal respiratory depression. NICE NG235
• Continuous monitoring of maternal and fetal well-being is essential during any sedation or analgesia in labour, including cardiotocography and respiratory function monitoring. NICE NG235
• Diazepam is contraindicated as an alternative to magnesium sulfate for eclampsia treatment and should not be used for seizure control in pregnancy. NICE NG133
• Benzodiazepines including diazepam should be avoided in breastfeeding mothers or used only at low doses and short duration due to accumulation risks and sedation in the infant. SmPC Diazepam,SmPC Diazepam,SmPC Diazepam,NHS Diazepam
• When sedation is used in the peripartum period, healthcare professionals must be trained and competent, with equipment and protocols to monitor cardiorespiratory status and manage potential complications. NICE CG112