Labor epidural analgesia versus without labor epidural analgesia for multiparous women: a retrospective case control study

Abstract

Background Labor epidural analgesia (LEA) effectively relieves the labor pain, but it is still not available consistently for multiparous women in many institutions because of their obviously shortened labor length. Methods A total of 811 multiprous women were retrospective enrolled and firstly divided into two groups: LEA group or non-LEA group. And then they were divided into seven subgroups and analyzed according to the use of LEA and cervical dilation. The primary outcomes (time intervals, blood loss and Apgar scores) and secondary outcomes (maternal demographic characteristics and birth weight) were collected by checking electronic medical records. Results The prevalence of using LEA in multiprous women was 54.5 %. Using LEA significantly lengthened the duration of labor stage by 56 min (P < 0.001), increased the blood loss (P < 0.001) and lowered Apgar scores (P = 0.001). In the comparison of sub-group analysis, using LEA can obviously prolong the duration of first-second stage in women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.014), while there was no significant difference with 4 cm or more cervical dilation (P = 0.69). Using LEA can significantly increased the blood loss when the initiation of LEA in the women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.035), meanwhile there were no significantly differences in the women with 4 cm or more cervical dilation (P = 0.524). Using LEA can significantly lower the Apgar scores when the initiation of LEA in the women with 2 cm cervical dilation (P = 0.001) and 4 cm or more cervical dilation (P = 0.025), while there were no significantly differences in the women with 3 cm cervical dilation (P = 0.839). Conclusions Labor epidural analgesia for the multiparous woman may alter progress of labor, increase postpartum blood loss and lower Apgar scores. Early or late initiation of LEA should be defined as with cervical dilatation of less or more than 3 cm and the different effect should be understand. Trial registration ChiCTR2100042746. Registered 27 January 2021-Prospectively registered, http://www.chictr.org.cn.

Impact of Intraspinal Nerve Block Anesthesia on Intrapartum Fever and the Neonate

“…Labor pain will elicit physiological stresses and perinatal complications [ 3 ]. Pregnant women choose cesarean delivery due to the fear of labor pain, which is one of the important influencing factors for the increasing rate of cesarean delivery in China [ 4 ]. Intraspinal nerve block anesthesia for labor analgesia features satisfactory nerve block and ideal analgesic effect, but the uncertainty of its effect on the labor process and the fetus has prevented its widespread implementation in China [ 5 ].…”

Epidural Analgesia in Labour and Its Obstetric Outcome

“…Out of 38 women who had normal vaginal delivery, 1 participant (2.6%) had postpartum hemorrhage .p value(less than 0.05) is statistically significant In a study conducted by Shuzhi Luo et al, early administration of epidural analgesia increases postpartum blood loss. 41 There was no Blood transfusion reported in the study population, no puerperal complications reported as well and no death had occurred in the study participants.…”

Epidural anesthesia during childbirth — retrospective analysis of maternal and neonatal results

“…Hung T-H. et al [39] investigating this topic, noticed a significantly higher percentage of newborn babies < 7 points in 1 minute of life in primigravida who were administered epidural analgesia. Luo S. et al [43] found that the use of epidural anesthesia during cervical dilatation of 2 cm or > 4 cm significantly reduces the Apgar score, while at the stage of 3 cm of cervical dilatation they did not find any differences.…”

“…Luo S. et al [43] deepened this analysis and found that the use of epidural anesthesia can significantly increase blood loss in women with 2 and 3 cm cervical dilatation. They did not show significant differences in women with dilatation of 4 cm or more [43].…”