From the Guidelines
Expectant fathers can experience injuries such as fractures, intracranial hemorrhage, or other organ damage due to syncope during epidural placement, and therefore, it is crucial to take preventive measures to minimize this risk. To prevent syncope and subsequent injuries, healthcare providers should encourage expectant fathers to maintain a safe position, such as sitting or lying down, during the epidural placement procedure 1. Some key points to consider include:
- Ensuring the father has eaten and is well-hydrated beforehand to prevent hypoglycemia and dehydration, which can exacerbate the risk of syncope
- Staff should be vigilant for signs of presyncope, such as pallor, sweating, lightheadedness, visual changes, and weakness, and intervene promptly by having the father assume a safe position or use physical counterpressure maneuvers (PCMs) if necessary 1
- PCMs, such as leg crossing with tensing or squatting, can help increase blood pressure and prevent syncope in individuals experiencing presyncope of vasovagal or orthostatic origin 1
- If syncope does occur, the father should be assessed for injuries, particularly head trauma, and monitored until fully recovered before being allowed to stand again
- Labor and delivery units can implement protocols to address this risk, including designated seating areas for partners and brief pre-procedure education about looking away during needle insertion It is essential to prioritize the safety and well-being of expectant fathers during epidural placement to prevent injuries and ensure a positive experience for both parents during this significant life event.
From the Research
Injuries to Expectant Fathers due to Syncope during Epidural Placement
- There is limited research directly addressing the specific question of injuries to expectant fathers due to syncope during epidural placement.
- However, studies on vasovagal syncope (VVS) suggest that it can be accompanied by traumatic injury, leading to morbidity and decreased quality of life, especially in those with VVS recurrence 2.
- The management of VVS includes non-pharmacologic and pharmacologic therapies, patient education and reassurance, salt and fluid intake increase, and physical counter-pressure maneuvers 2, 3.
- Expectant fathers may experience anxiety and stress during labor, which can be reduced by the presence of maternal epidural analgesia 4, 5.
- There is no direct evidence on the injuries that expectant fathers can experience due to syncope during epidural placement, but it is possible that they may be at risk of traumatic injury if they experience VVS while witnessing their partner's epidural placement.
- A study on epidural blood patch found that syncope during the procedure can lead to vision loss due to Terson syndrome, highlighting the potential risks associated with epidural procedures 6.