RESUMEN
Background: Labour is one of the most painful experiences women encounter during their lifetime and the experience is different for each women. Aim of the study was to evaluate the effect of low dose intrathecal labour analgesia using fentanyl, bupivacaine and morphine on maternal and fetal outcome.Methods: 100 parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4-6cm were enrolled for the study. They were randomized into two groups of 50 each, using computer based block randomization. Group 1 (N=50) received intrathecal labor analgesia using. Fentanyl (25µg), bupivacaine (2.5mg) and morphine (250µg) and Group 2 (N=50) received programmed labor. The two groups were well matched in terms of age, weight, height, parity, baseline vitals and mean cervical dilatation at the time of administration of labor analgesia . Progress of labor, duration of analgesia, and neonatal APGAR score were recorded. Feto-maternal and neonatal outcomes were studied and compared between the two groups.Results: The mean duration of analgesia in group1 was 238.96±21.888 min whereas the mean duration of analgesia in group 2 was 98.4±23.505 min. The difference was significant P value 0.00. One out of 50 (2%) of the parturients required rescue analgesia in Group 1. On the contrary all 44 parturients in Group 2 required rescue analgesia. Difference was significant (p value=0.00) However duration of the stages of labor, operative and instrumental deliveries and APGAR score did not differ in the two groups.Conclusions: Single shot intrathecal labor analgesia is a safe, effective, reliable, cheap and satisfactory method of pain relief for labor and delivery. Moreover, it is devoid of major side effects.
RESUMEN
To evaluate the efficacy of Programmed Labor protocol in providing shorter, safer and a relatively pain free delivery.The study was conducted in Obstetrics & Gynecology deptt of Christian Medical College & Hospital, Ludhiana. 30 primigravidae were included into the study and treated as per protocol. Labor outcome was analyzed in terms of mean rate of cervical dilatation, mean duration of first, second and third stages of labor, average blood loss, mode of delivery, maternal and neonatal morbidity. 50 primigravidae as controls were also included in the study and analyzed for the same parameters. The mean rate of cervical dilatation in the study group was 2.3cm/hr, which was almost double of the control group. There was marked shortening of all the stages of labor. Average blood loss was comparatively less in the study group. 70% of women in the study group had significant pain relief. Majority of women in the study group delivered vaginally. 2 (6.7%) babies born to these mothers had an Apgar Score < 7 but there was no perinatal mortality. Programmed labor protocol can safely lead to shorter labors and significant pain relief without any major increase in maternal or neonatal morbidity.