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Vol 94, No 9 (2023)
Research paper
Published online: 2023-06-07
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Epidural analgesia: effect on labor duration and delivery mode — a single-center cohort study

Aleksandra Olszynska1, Zofia Di Martino1, Agnieszka Pawlowska1, Stepan Feduniw23, Jan Modzelewski4, Anna Kajdy4, Dorota Sys5, Grazyna Baczek6, Michal Rabijewski7
DOI: 10.5603/GP.a2023.0048
·
Pubmed: 37284824
·
Ginekol Pol 2023;94(9):733-740.
Affiliations
  1. Medical University of Warsaw, Poland
  2. Department of Obstetrics, University Hospital Zurich, Switzerland, Switzerland
  3. Department of Gynecology, University Hospital Zurich, Switzerland
  4. 1st Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland, Poland
  5. Department of Medical Statistics, School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
  6. Department of Gynecology and Obstetrics Didactics Faculty of Health Sciences Warsaw Medical University, Warsaw, Poland, Poland
  7. Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland

open access

Vol 94, No 9 (2023)
ORIGINAL PAPERS Obstetrics
Published online: 2023-06-07

Abstract

Objectives: Parturients in labor experiencing severe pain may develop several complications, which could be avoided using various forms of labor analgesia. Researchers hold divergent opinions about the effect of epidural analgesia (EA) on labor duration and delivery mode. This paper aims to establish if EA affects the duration of the 1st and the 2nd phase of labor and the percentage of emergency Cesarean sections (CS) and instrumental delivery. Material and methods: The patients in this cohort study were recruited at St. Sophia’s Specialist Hospital in Warsaw, between 1/1/2020 and 6/1/2020. We used following inclusion criteria: patients aged 18–40 with singleton pregnancies and cephalic presentation of the fetus who gave live birth at a gestational age of 37–42 weeks to neonates with birthweight 2500–4250 g and received EA at the cervical dilation between three and six centimeters. The control group didn’t receive anesthesia. We excluded planned CS and vaginal births after CS. Data analysis was performed for all parturients and separately for multiparas and nulliparas. Results: Out of 2550 deliveries, we included 1052 patients — 443 participants with EA and 609 in the control group. Patients with epidural analgesia experienced longer labor 415 vs 255 min (p < 0.01), longer 1st and 2nd stage (p < 0.01). They had a lower risk of emergency CS (OR = 0.56) (p < 0.01) but were more likely to have instrumental delivery. Conclusions: EA prolongs the first and the second stage of labor yet doesn’t affect neonatal outcomes. Moreover, the risk of emergency CS in nulliparas with EA is three times lower.

Abstract

Objectives: Parturients in labor experiencing severe pain may develop several complications, which could be avoided using various forms of labor analgesia. Researchers hold divergent opinions about the effect of epidural analgesia (EA) on labor duration and delivery mode. This paper aims to establish if EA affects the duration of the 1st and the 2nd phase of labor and the percentage of emergency Cesarean sections (CS) and instrumental delivery. Material and methods: The patients in this cohort study were recruited at St. Sophia’s Specialist Hospital in Warsaw, between 1/1/2020 and 6/1/2020. We used following inclusion criteria: patients aged 18–40 with singleton pregnancies and cephalic presentation of the fetus who gave live birth at a gestational age of 37–42 weeks to neonates with birthweight 2500–4250 g and received EA at the cervical dilation between three and six centimeters. The control group didn’t receive anesthesia. We excluded planned CS and vaginal births after CS. Data analysis was performed for all parturients and separately for multiparas and nulliparas. Results: Out of 2550 deliveries, we included 1052 patients — 443 participants with EA and 609 in the control group. Patients with epidural analgesia experienced longer labor 415 vs 255 min (p < 0.01), longer 1st and 2nd stage (p < 0.01). They had a lower risk of emergency CS (OR = 0.56) (p < 0.01) but were more likely to have instrumental delivery. Conclusions: EA prolongs the first and the second stage of labor yet doesn’t affect neonatal outcomes. Moreover, the risk of emergency CS in nulliparas with EA is three times lower.

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Keywords

cesarean section; parturition; epidural anesthesia; parity

About this article
Title

Epidural analgesia: effect on labor duration and delivery mode — a single-center cohort study

Journal

Ginekologia Polska

Issue

Vol 94, No 9 (2023)

Article type

Research paper

Pages

733-740

Published online

2023-06-07

Page views

750

Article views/downloads

633

DOI

10.5603/GP.a2023.0048

Pubmed

37284824

Bibliographic record

Ginekol Pol 2023;94(9):733-740.

Keywords

cesarean section
parturition
epidural anesthesia
parity

Authors

Aleksandra Olszynska
Zofia Di Martino
Agnieszka Pawlowska
Stepan Feduniw
Jan Modzelewski
Anna Kajdy
Dorota Sys
Grazyna Baczek
Michal Rabijewski

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