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Delivery and labour pain is normally the most painful event in a woman's lifetime. Physical and psychological factors may influence the severity of labour pain, and labour pain relief is an important issue for the obstetric anaesthetist. We describe the current most effective pharmacological techniques used for labour analgesia: systemically with remifentanil and regionally with epidural analgesia.

This is an update on the treatment of anaphylactic shock in pregnant women. Most guidelines recommend adrenaline as first-line treatment in all patients, but in pregnant patients some recommend ephedrine due to a potential risk of utero-placental hypoperfusion with adrenaline. However, ephedrine is a less potent vasopressor than adrenaline and does not possess the same anti-inflammatory or broncho-dilating effects. As immediate and correct treatment is essential for both the maternal and the fetal outcome, adrenaline should be first-line treatment also in pregnant women.