EPIDURAL LABOUR ANALGESIA IN IZOLA GENERAL HOSPITAL
Background. The study presents the experience with epidural analgesia (EPA) for pain relief in Izola General Hospital from 2003 to 2006, the differences of labour between epidural analgesia and without it and the parturients’ satisfaction.
Methods. A retrospective observational study was performed. Data were compared between 214 parturients with EPA matched by 214 parturients without. The control parturient was the equiipara with a term birth and the cephalic presentation of fetus that delivered just before the parturient of the EPA group. Maternal age, labor length, rate of oxitocin use, instrumental deliveries and cesarean sections, Apgar scores and birthweights were compared. The questionnaire was used to estimate the pain in 62 parturients.
Results. In GH Izola in 214 parturients (10 %) EPA was applied for labour pain relief in the period from July 2003 till December 2006. In the EPA group there was a statistically significance compared with the control group: higher parturients’ mean age (30.5 vs 28.7 y.o.; p < 0.0005), longer labour length (278 vs 222 min; p < 0.0005), higher oxitocin use rate (93.4 % vs 72.9 %; p < 0.0001) and higher instrumental delivery rate (vacuum extraction 14 % vs 1.9 %; p < 0.0001). The cesarean section rates were equal in both groups. Despite the higher instrumental delivery rate and the longer labour length in the EPA group there were no worse perinatal outcomes, neither was statisticaly significant difference in Apgar scores compared with the control group. The mean intensity of pain was highest before the EPA application (VAS 7), lowest during the transition stage (VAS 1.5) and some higher during the second phase (VAS 2.7). Most of parturients in the EPA group were satisfied; 92 % of them evaluated the EPA as good or very good.
Conclusions. EPA is a very effective method for pain control during labor. The parturients’ satisfaction with this pain control method is appropriate. Despite the higher instrumental delivery rate and the longer labour length EPA didn’t worsen the perinatal outcome.
Howell CJ. Epidural versus non-epidural analgesia for pain relief in labour Cochrane Database Syst Rev 2003; CD00033.
Leighton BL, Halpern SH. The effect of epidural analgesia on labor, maternal, and neonatal outcomes: A systematic review. Am J Obstet
Gynecol 2002; 186: S69–77.
Decca L, Daldoss C. Labor course and delivery in epidural analgesia: a case-control study.: A systemic review. Am J Matern Fetal Neonatal
Med 2004; 16: 115–8.
Lovšin B, Pavlovič G, Guzej Z, Kosmina B, Priman T, Deisinger D. Introduction of epidural labour analgesia in a regional maternity
hospital. J Perinat Med 2005; 33 Suppl 1: 207.
Liu EH, Sia AT. Rates of caesarean section and instrumental vaginal delivery in nulliparous women after low concentration epidural
infusions or opioid analgesia: systematic review. BMJ 2004; 328: 1410.
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