ABSTRACT
Objective:To evaluate the efficacy of epidural labor analgesia in the latent phase for the re-pregnant parturients with scar uterus.Methods:One hundred re-pregnant parturients with scar uterus who were at full-term with a singleton fetus in vertex presentation, aged 26-38 yr, with height between 158-170 cm, weighing 61-95 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups ( n=50 each) using a random number table method: epidural labor analgesia in active phase group (group A) and epidural labor analgesia in latent phase group (group B). Epidural labor analgesia was performed in active phase of labor (cervical dilatation≥3 cm) in group A and in latent phase of labor (cervical dilatation≥1 cm) in group B. Epidural labor analgesia solution contained the mixture (100 ml) of 0.1% ropivacaine and sufentanil 0.5 μg/ml, and the analgesia pump was set up to deliver a 5 ml bolus dose with a 30-min lockout interval and background infusion 8 ml/h and then turned off after delivery of fetus.Visual analogue scale scores were recorded on admission to the labor room, when the cervical dilation was 1, 2, 3, 4 and 10 cm and at the time point immediately after delivery.The labor time, volume of postpartum hemorrhage, emergency cesarean section, decision-to-delivery interval, Apgar score of the newborn at 1 min after birth and results of umbilical cord blood gas analysis were recorded. Results:Compared with group A, the visual analogue scale scores in latent phases of labor were significantly decreased at each time point of latent phases, the duration of the first stage of labor was prolonged, the rate of emergency cesarean section was decreased, and the decision-to-delivery interval was shortened ( P<0.05), and no significant change was found in the volume of postpartum hemorrhage in group B ( P>0.05). There was no significant difference in the Apgar score of the newborn and results of umbilical cord blood gas analysis between two groups ( P>0.05). Conclusion:Epidural labor analgesia performed in the latent phase provides better efficacy than that performed in the active phase when used for the re-pregnant parturients with scar uterus.