The effect of epidural analgesia on maternal-neonatal outcomes: a retrospective study

Liu, Xingxing; Zeng, Rong; Chen, Qifeng; Ke, Di

doi:10.5603/gp.a2021.0007

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…al. [22] any adverse outcomes of child and mother were found significant. The longer hospital stay was also observed in a study of Yin and Hu [23], and was probably related to increased rate of maternal intrapartum fever.…”

Section: Discussionmentioning

confidence: 86%

Epidural analgesia: effect on labor duration and delivery mode — a single-center cohort study

Olszynska,

Di Martino,

Pawlowska

et al. 2023

Ginekol Pol

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Objectives: Parturients in labor experiencing severe pain may develop several complications, which could be avoided using various forms of labor analgesia. Researchers hold divergent opinions about the effect of epidural analgesia (EA) on labor duration and delivery mode. This paper aims to establish if EA affects the duration of the 1 st and the 2 nd phase of labor and the percentage of emergency Cesarean sections (CS) and instrumental delivery. Material and methods:The patients in this cohort study were recruited at St. Sophia's Specialist Hospital in Warsaw, between January 1st, 2020, and June 1st, 2020 . We used following inclusion criteria: patients aged 18-40 with singleton pregnancies and cephalic presentation of the fetus who gave live birth at a gestational age of 37-42 weeks to neonates with birthweight 2500-4250 g and received EA at the cervical dilation between three and six centimeters. The control group didn't receive anesthesia. We excluded planned CS and vaginal births after CS. Data analysis was performed for all parturients and separately for multiparas and nulliparas.Results: Out of 2550 deliveries, we included 1052 patients -443 participants with EA and 609 in the control group. Patients with epidural analgesia experienced longer labor 415 vs 255 min (p < 0.01), longer 1 st and 2 nd stage (p < 0.01). They had a lower risk of emergency CS (OR = 0.56) (p < 0.01) but were more likely to have instrumental delivery. Conclusions:Epidural analgesia prolongs the first and the second stage of labor yet doesn't affect neonatal outcomes. Moreover, the risk of emergency CS in nulliparas with EA is three times lower.

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Section: Discussionmentioning

confidence: 86%

Epidural analgesia: effect on labor duration and delivery mode — a single-center cohort study

Olszynska,

Di Martino,

Pawlowska

et al. 2023

Ginekol Pol

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“…Ballesteros-Meseguer et al (2016) and Shmueli et al (2017) also showed a tendency to perform an episiotomy in women who received epidural anesthesia [ 31 , 32 ]. In contrast, in a study by Liu et al (2021), no significant correlations were found between epidural anesthesia and the frequency of episiotomy [ 33 ].…”

Section: Discussionmentioning

confidence: 86%

Episiotomy for Medical Indications during Vaginal Birth—Retrospective Analysis of Risk Factors Determining the Performance of This Procedure

Bączek

Rychlewicz²,

Sys

et al. 2022

JCM

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The WHO (World Health Organization) recommends that the percentage of perineal incisions should not exceed 10%, indicating that this is a good goal to achieve, despite the fact that it is still a frequently used medical intervention in Poland. The risk factors for perineal incision that have been analyzed so far in the literature allow, among others, to limit the frequency of performing this procedure. Are they still valid? Have there been new risk factors that we should take into account? We have conducted this study to find the risk factors for performing perineal incision that would reduce the frequency of this procedure. The aim of the study was to check whether the risk factors that were analyzed in the literature are still valid, to find new risk factors for perineal incisions and to compare them among Polish women. This was a single-center retrospective case-control study. The electronic patient records of Saint Sophia’s Hospital in Warsaw, Poland, a tertiary hospital was used to create an anonymous retrospective database of all deliveries from 2015 to 2020. The study included the analysis of two groups, the study group of patients who had had an episiotomy, and the control group-patients without an episiotomy in cases where an episiotomy was indicated. A logistic regression model was developed to assess the risk factors for perineal laceration. Independent risk factors for episiotomy in labor include oxytocin use in the second stage of labor (OR (Odds Ratio) = 6.00; 95% CI (Confidence Interval): 4.76–7.58), the supply of oxytocin in the first and the second stage of labor (OR = 3.18; 95% CI: 2.90–3.49), oxytocin use in the first stage of labor (OR = 2.72; 95% CI: 2.52–3.51), state after cesarean section (OR = 2.97; 95% CI: 2.52–3.51), epidural anesthesia use (OR = 1.77; 95% CI: 1.62–1.93), male gender (OR = 1.10; 95% CI: 1.02–1.19), and prolonged second stage of labor (OR = 1.01; 95% CI: 1.01–1.01). A protective factor against the use of an episiotomy was delivery in the Birth Centre (OR = 0.43; 95% CI: 0.37–0.51) and mulitpara (OR = 0.31; 95% CI: 0.27–0.35). To reduce the frequency of an episiotomy, it is necessary consider the risk factors of performing this procedure in everyday practice, e.g., limiting the use of oxytocin or promoting alternative places of delivery.

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“…Epidural labor analgesia (ELA) is widely used. Although it can greatly reduce maternal labor pain, studies have found that ELA drugs affect the normal reflex arc of urination, weaken the contraction of abdominal muscles and the diaphragm, cause urination and bladder pain, as well as postpartum urinary retention [ 1 , 2 , 3 , 4 , 5 ]. Direct bladder catheterization is the solution to urinary retention during and after delivery.…”

Section: Introductionmentioning

confidence: 99%

Auricular bean embedding improves urination in epidural labor analgesia: A single center randomized controlled study

Sheng

Jiang

Zheng

et al. 2023

THC

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BACKGROUND: Acupoint buried beans on the auricle is a feasible method to prevent and treat postpartum urinary retention. OBJECTIVE: This study investigated the effect of auricular acupoint buried beans on postpartum urination and maternal and fetal outcomes following epidural analgesia for labor. METHODS: Two hundred forty primiparas underwent vaginal trial labor analgesia from May 2020 to January 2021 and were randomly placed into the intervention and control groups. Both groups received epidural labor analgesia. Maternal urination during labor, 2 h postpartum, and the time for first postpartum urination were recorded as primary outcomes, with maternal and infant outcomes documented as secondary results. Statistical analysis was performed using the independent sample t-test, non-parametric rank-sum, or chi-square test using the SPSS Statistics 25.0 software. RESULTS: Two hundred eight study participants were subsequently included in the results, i.e., 105 patients in the intervention group and 103 in the control group. The intervention group comprised a significantly lower number of patients with excessive residual urine volume at cervical dilatation of 5–6 cm (P< 0.05). The total postpartum score of the intervention group was lower than in the control group (P< 0.01), and the time to first urination was shorter compared with the control group (P< 0.05). In the intervention group, the time of labor analgesia, the duration of the first stage of labor, and the total labor time were shorter compared with the control group (P< 0.01). CONCLUSION: Auricular acupoint embedded beans can improve the urination status at cervical dilatation of 5–6 cm and 2 h postpartum, as well as significantly shorten the duration of labor.

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The effect of epidural analgesia on maternal-neonatal outcomes: a retrospective study

Cited by 5 publications

References 25 publications

Epidural analgesia: effect on labor duration and delivery mode — a single-center cohort study

Epidural analgesia: effect on labor duration and delivery mode — a single-center cohort study

Episiotomy for Medical Indications during Vaginal Birth—Retrospective Analysis of Risk Factors Determining the Performance of This Procedure

Auricular bean embedding improves urination in epidural labor analgesia: A single center randomized controlled study

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