To study the effect of epidural analgesia on second stage of labor and mode of delivery

Abstract

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

Effect of epidural analgesia on the duration of labour and pains: a comparative study

“…This was indicated by the normal Apgar score, the absence of need for naloxone, or mechanical ventilation for the neonates. This result was similar to the study conducted by Sahu et al and Agarwal et al 8,9 The mean VAS score at 4 cm dilated cervix does not show any difference in the epidural and control group before the administration of epidural analgesia. But the patients who received epidural analgesia had less VAS score at the time of fully dilated cervix than the patient who did not demand epidural analgesia.…”

“…There was prolongation of duration of 2 nd stage of labour in the study group requesting epidural analgesia for pain relief. The result of present study correlated with the study done by Sahu et al, Agarwal et al, Rimaitis et al and Mousa et al [8][9][10][11] There was no statistically significant difference observed between two groups when comparing the rate of caesarean sections and normal vaginal deliveries. The indication for the caesarean deliveries in control group was previous section with scar tenderness and that of epidural group were foetal distress and failure of induction.…”

“…There was significant difference between pre and post epidural VAS score. The similar result found in the study done by Sahu et al, and Sikdar et al 8,20 Patients had some of the undesirable effects also after receiving epidural analgesia. Hypotension (fall in systolic BP >20 mmHg) was observed in 3 patients from study group and in no patient in control group.…”

Evaluation of the effects of epidural labour analgesia on mode of delivery

“…Here, 𝑃 1 =Proportion of prolonged 2 nd stage with epidural analgesia=36%, 𝑃 2 =Proportion of prolonged 2 nd stage without epidural analgesia=10%. 16 Z α =1.96 (at 5% level of significance), Z β = 1.28 (at 90 % power) Therefore, n = 36 ( 100−36 )+10(100−10) (36−10) 2 (1.96 + 1.28) 2 =49.75 There were two groups, group A (with epidural analgesia) consisted of 50 and group B (without epidural analgesia) contained 50. The inclusion criteria of our study were maternal age (18-35 years), gestation week (37-41 weeks), women in labour diagnosed by regular uterine contractions and at least 4 cm cervical dilatation, normal foetal heart rate pattern (CTG) before starting epidural analgesia.…”

“…The goal is to provide pain relief during labour. 2 In developed countries, as many as 50% of all parturient are epidural users; whereas up to 81% of nulliparous parturient are epidural users. 3 form of analgesia and is often the preferred choice of analgesia.…”