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Impact of Epidural Analgesia in Labour onNeonatal and Maternal Outcomes
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology. Department of Obstetrics and Gynecology, Örnsköldsvik Hospital, Örnsköldsvik, Sweden.
2018 (English)In: Open Journal of Obstetrics and Gynecology, ISSN 2160-8792, E-ISSN 2160-8806, Vol. 8, p. 767-779Article in journal (Refereed) Published
Abstract [en]

AimTo evaluate the effect of epidural analgesia during labour on neonatal-maternal outcomes. 

Methods: A retrospective cohort study of nulliparous parturients who gave birth in Vasternorrland County, Sweden, over a 2-year period between 2015 and 2016. Neonatal outcomes (Apgar score at 5 min and umbilical cord arterial blood gases), maternal outcomes (perineal injury, total bleeding volume and maternal satisfaction with birth) and labour parameters (mode of delivery and the durations of labour and postpartum hospital stay) were evaluated. 

Results: The study cohort consisted of 1449 women with singleton pregnancies. Patients were divided into two groups according to whether during labour they were administered epidural analgesia using bupivacaine and sufentanil (EDA group, n = 615) or not (non-EDA group, n = 834). The rate of assisted vaginal delivery was significantly higher in the EDA group than in the non-EDA group (15.6% and 11.3%, respectively, p < 0.05), whereas the rates of caesarean section were similar. The duration of the active phase of labour was significantly longer in the EDA group than in the non-EDA group (489 ± 217 min versus 371 ± 210 min, respectively, p < 0.001). The Apgar score at 5 min and umbilical cord blood pH were lower and the base deficit greater in the EDA group (p < 0.001, p < 0.001 and p < 0.01, respectively). Bleeding volume was similar between the groups after adjusting for gestational age. Women in the EDA group were more satisfied with their labour experience, as measured by the visual analogue scale (p < 0.05). 

Conclusion: The results of this study suggest that EDA affects delivery and neonatal-maternal outcomes negatively, but increases the mother’s satisfaction with labour.

Place, publisher, year, edition, pages
Scientific Research Publishing, 2018. Vol. 8, p. 767-779
Keywords [en]
Obstetric, Visual Analogue Scale, Maternal Satisfaction, Apgar Score, Perineal Injury, Mode of Delivery, Foetal Blood Gases
National Category
Medical and Health Sciences Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:umu:diva-158015DOI: 10.4236/ojog.2018.89080OAI: oai:DiVA.org:umu-158015DiVA, id: diva2:1303644
Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2019-04-16Bibliographically approved

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Turkmen, Sahruh

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