A study of the effects of epidural analgesia on the course of labor and delivery mode / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: This study was designed to evaluate the effect of epidural analgesia on the course of labor and delivery mode. METHOD: Three hundred eighteen term pregnant women with singleton fetus in vertex presentation were admitted for vaginal delivery at the Department of Obstetrics and Gynecology, medical center Chung-ju hospital from January 1, 1998 to December 31, 1998. They were divided into two groups epidural analgesia group and non-epidural analgesia group. Epidural analgesia group was 106 women (79 primiparas and 27 multiparas). Non-epidural analgesia group was 212 women (138 primiparas and 74 multiparas). Course of labor and delivery mode were compared between the two groups. RESULTS: 1. The duration of the first stage of labor was not significantly different between two groups (primiparas 672+/-110 min vs 625+/-134 min, multiparas 458+/-152 min vs 422+/-184 min), and that of the second stage of labor in the primiparas was significantly longer in epidural analgesia group than non-epidural analgesia group (62+/-25 min vs 42+/-20 min, p=0.03), but did not differ significantly in the multiparas groups (36+/-12 min vs 31+/-20 min).2. Cesarean delivery rates were not significantly different between two groups (19.8% vs 15.1%).3. Cesarean delivery rates due to failure to progress were not significantly different between two groups (85.7% vs 78.1%).4. Oxytocin augmentation rates were significantly higher in epidural analgesia group than in non-epidural analgesia group (primiparas 42.3% vs 20.1%, p=0.008, multiparas 38.5% vs 19.7%, p=0.01).5. The newborn birthweight, Apgar score and the incidence of meconium-stained amnionic fluid were not significantly different between two groups.6. The complication of the epidural analgesia were back pain (10.4%), shivering (7.5%), nausea and vomiting (1.3%), hypotension (0.9%), and voiding difficulty (0.9%). CONCLUSION: Though epidural analgesia prolonged second stage of labor in the primiparas and increased oxytocin augmentation rates but did not increased the cesarean delivery rates. So intrapartum epidural analgesia provided safe and effective pain control without undesirable effects on labor outcomes.