Adverse effects of epidural analgesia in labor

Objective: To examine the influence of epidural analgesia on labor and delivery in nulliparous and multiparous women. Design: Data were collected on 847 consecutive parturients with singleton pregnancy and vertex presentation (384 nulliparous and 463 multiparous). The obstetrical and labor character...

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Published in:European journal of obstetrics & gynecology and reproductive biology 2000-04, Vol.89 (2), p.153-157
Main Authors: Zimmer, Etan Z., Jakobi, Peter, Itskovitz-Eldor, Joseph, Weizman, Boris, Solt, Ido, Glik, Aldo, Weiner, Zeev
Format: Article
Language:English
Subjects:
Adult
Analgesia, Epidural - adverse effects
Analgesia, Obstetrical - adverse effects
Biological and medical sciences
Cesarean section
Delivery, Obstetric
Delivery. Postpartum. Lactation
Disorders
Epidural analgesia
Female
Gynecology. Andrology. Obstetrics
Humans
Instrumental delivery
Labor
Labor Stage, Second
Medical sciences
Pregnancy
Second stage of labor
Spontaneous delivery
Time Factors
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Summary:Objective: To examine the influence of epidural analgesia on labor and delivery in nulliparous and multiparous women. Design: Data were collected on 847 consecutive parturients with singleton pregnancy and vertex presentation (384 nulliparous and 463 multiparous). The obstetrical and labor characteristics including maternal age, parity, gestational age, previous cesarean section, instrumental delivery, mode and timing of analgesia, mode of delivery, indications for cesarean section or instrumental delivery were analyzed comparing patients who received epidural analgesia with women who received systemic analgesia. Results: Epidural analgesia was administered in 233 nulliparous and 141 multiparous women. A stepwise logistic regression analysis revealed that epidural analgesia independently affected the rate of non-spontaneous delivery and the duration of the second stage of labor in nulliparous ( P=0.0017 and P=0.0036, respectively) and multiparous ( P=0.001 and P=0.0081, respectively) women. Epidural analgesia independently affected the duration of labor only in nulliparous women ( P=0.0001). Conclusion: Women should be informed that prolongation of labor and increase in nonspontaneous deliveries should be expected when choosing epidural analgesia in labor.
ISSN:0301-2115
1872-7654
DOI:10.1016/S0301-2115(99)00191-8