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Effects of Epidural Analgesia: Some Questions and Answers
Author(s) -
Thorp James A.,
McNitt Jay D.,
Leppert Phyllis C.
Publication year - 1990
Publication title -
birth
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.233
H-Index - 83
eISSN - 1523-536X
pISSN - 0730-7659
DOI - 10.1111/j.1523-536x.1990.tb00725.x
Subject(s) - medicine , oxytocin , fetal distress , cephalic presentation , anesthesia , obstetrics , apgar score , gestational age , combined spinal epidural , vaginal delivery , fetus , pregnancy , biology , genetics
The effects of epidural analgesia on first labors have been studied by Thorp and colleagues (1,2). One study has been published (3) and is the subject of a question‐and‐answer discussion, presented here. In this study 711 consecutive nulliparous women at term, with spontaneous onset of labor and cephalic presentation, were divided into one group (n = 447) who received epidural analgesia in labor and another group (n = 264) who received narcotics or no analgesia. The frequency of cesarean section for dystocia was significantly greater (p < 0.005) in the epidural group (10.3%) than in the nonepidural group (3.8%), even after selection bias was corrected and the variables of maternal age and race; gestational age; cervical dilatation on admission; use, duration, and maximum infusion rate of oxytocin; labor duration; presence of meconium; and birth weight were controlled. For both groups the frequency of cesarean section for fetal distress was similar (p < 0.20), and the frequency of low Apgar scores at 5 minutes and cord blood gas values showed no significant differences. The authors concluded that “epidural analgesia in labor may increase the incidence of cesarean section for dystocia in nulliparous women’(3).