Epidural analgesia is regional anaesthesia that blocks pain in a particular region of the body. The use of epidural analgesia (EA) in labor is widespread in modern labor ward practice, and its benefits in terms of pain relief are well-recognized. Aims: To study the effect of epidural analgesia on second stage of labor, maternal and neonatal outcomes and its efficacy in labor.Study Design: This is Prospective Cohort Study was carried at Dr. L. H. Hiranandani Hospital. All the women admitted in labour room for delivery were divided into 2 groups. 1. Case Group: Included 84 women who opted for epidural analgesia. 2. Control Group: Included 90 women who did not take epidural analgesia. Results: The 2 nd stage of labor in epidural group was 54.61 (± 37.24) mins and 37.36 (± 26.79) mins in the non epidural analgesia group. By using unpaired t-test, it was found that the data was significant (p=0.032). The incidence of caesarean section in the epidural group was 16.66% and the in non-epidural group was 12.22%. It was observed that epidural analgesia did not increase the rate of instrumental delivery or caesarean section. The mean VAS Score before epidural analgesia was 6.2 (± 1.07) whereas it was 3.95 (± 1.46) after epidural analgesia. On applying Wilcoxon Matched Pair test, it was found that the pain was reduced significantly in the mothers after receiving the epidural analgesia. Conclusion: Epidural analgesia can be safely recommended as a method of labor analgesia. Epidural analgesia has no significant adverse effects on maternal and neonatal outcomes
In modern obstetrics, one of the common challenges is induction of labour (IOL). WHO Global Survey reported that IOL accounted for 9.6% of all deliveries. Prostaglandins have evolved and frequently used pharmacologic agents for IOL, owing to their dual action of cervical ripening and uterine contraction inducing effect. : 1. To compare the efficacy and induction to delivery interval (IDI) of PGE2 vaginal insert and Sublingual PGE1 in induction of labor in term pregnant women; 2. To study the maternal and fetal outcome in both groups.: This a randomized, prospective, comparative study of 100 term pregnant women for induction of labour. Group 1-(50 women) PGE2-10mg vaginal insert and group 2-(50 women) PE1 Sublingual tablets – maximum 200 mcg in 24 hrs, at Dr LH Hiranandani Hospital, Mumbai, India.: In my study the mean induction to delivery interval in Dinoprostone group was 17.47 hours and 23.44 hours in Misoprostol group. So the mean IDI was shorter in Dinoprostone insert group than Misoprostol group by about 6 hours. There was no significant difference noted in terms of overall incidence of caesarean deliveries among the groups. Our study concluded that Dinoprostone 10mg vaginal insert was more efficacious than sublingual Misoprostol in reducing induction to delivery interval without maternal and fetal complications.Our study suggests that the Dinoprostone vaginal insert can be used as both inducing as well as augmentating agent in labour. Dinoprostone vaginal insert maybe more effective in reducing the incidence of caesarean sections.
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