Khurshid Shabbir Raja, Huma Tasleemahi.
Influence of epidural analgesia on frequency of instrumental delivery and duration of labor.
Rawal Med J Jan ;34(1):86-8.

Objective To observe the rate of instrumental delivery in parturients having Epidural Analgesia in labour and its effects on duration of labour. Method This comparative cross sectional study was conducted in Shifa Foundation Community Health Center and Shifa International hospital after approval from Ethical Committee and Institutional Review Board. Out of 156 parturient included, 78 patients had Epidural Analgesia for labour and 78 did not. Epidural was administered with cervical dilatation less than 5 cm or when the contractions became regular. All women in labour were at term and preterm deliveries were excluded. Duration of second stage of labour was recorded and mode of delivery was noted. Results In 78 patients undergoing epidural analgesia, mean duration of second stage of labour was 22 minutes. Thirty nine percent patients had spontaneous vaginal delivery (N=31), 28% were delivered by vacuum (N=32), 10% had forceps delivery (N=7) and remaining 23% patients had C-section (N=18). In 78 patients who did not have Epidural analgesia, mean duration of second stage of labour was 11.34 minutes. Fifty two percent patients had spontaneous vaginal delivery (N=41), 5.1% delivered by vacuum (N=4), 6.4% had forceps delivery (N=5) and 35.9% patients had C-section (N=28). Conclusions Our study revealed that epidural analgesia is associated with an increased risk of instrumental vaginal delivery and prolonged second stage of labour. (Rawal Med J 2009; 34: 86-88).

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