The influence of epidural analgesia on the course of labor

Abstract

Summary Objective: The aim of the study was to analyze the influence of epidural analgesia (EA) on the course of labor. Material and methods: The study group consisted of 191 women with EA („walking anesthesia”). 209 women without EA were chosen for controls. All the patients delivered at the 1st Dept of Obstetrics and Gynecology, Medical University of Warsaw, Poland. T-test and chi2 test were used for statistical analysis and p<0.05 was considered statistically significant. Results: There were no significant differences between the groups regarding age, parity, weight, average birth weight of newborns and the rate of preterm deliveries. The first and second stage of labor were significantly longer in EA group (p<0.01). The velocity of dilatation was significantly slower in the study group until 3-5cm (0.87 vs. 1.34cm/h). After EA was applied, the acceleration of dilatation was, however, significantly greater than among controls (4.27 times vs. 3.2 times). The rate of CS was similar in both groups, however, the indications for it differed significantly: fetal asphyxia 22% vs. 50% (p=0.04), occiput posterior 22% vs. 4% (p=0.009) in EA vs. controls, respectively. There were no differences between the groups regarding the general condition of the newborns. Conclusions: The overall longer first stage of labor in patients from the study group can result from the characteristics of women more than from EA itself, as EA seems to accelerate the dilatation of the cervix. EA does not affect the incidence of operative delivery, however, it may change the indications to cesarean section. EA has no impact on the condition of the newborns.