The course of labor with and without epidural analgesia

J. Alexander, M. Lucas, S. Ramin, D. Mrlntire, K. Leveno

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To measure effects of epidural analgesia on labor when compared to boluses of meperidine in a cohort of women with identical clinical circumstances. STUDY DESIGN: 199 nulliparous women who delivered spontaneously at term and who received oxytocin for labor augmentation prior to the initiation of analgesia were identified for analysis. All of these women were managed in a low risk labor unit using a standardized protocol. This management protocol encouraged early amniotomy and use of oxytocin when ineffective labor was diagnosed. RESULTS: The demographic characteristics of the two study groups were similar with respect to age, height, weight, and maternal age. The two groups had the same cervical dilatation on admission (3.3 cm) and at the time of analgesia administration (4.1 versus 4.2 cm) indicating similar progress of labor prior to oxytocin administration. The length of the active phase of labor was longer in the epidural grotip (7.9 versus 6.3 hours, p = .005) as was the 2nd stage (60 versus 48 minutes, p = .03). The mean and maximal rates of oxytocin infusion were similar between the two study groups; however, the amount of oxytocin required for each centimeter of cervical change was more in the epidural group (22 versus 16 mU's per cm of cervical change, p = .009). Neonatal outcomes were unaffected by the type of labor analgesia. CONCLUSIONS: Epidural analgesia decreases uterine performance during oxytocin stimulated labor resulting in an increase in the length of the first and second stages of labor.

Original languageEnglish (US)
Pages (from-to)S189
JournalActa Diabetologica Latina
Volume176
Issue number1 PART II
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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