Evaluation of the effects of epidural labour analgesia on mode of delivery

Marufa Khatun, M. A. Rahim, Fatema Rahman
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Abstract

Background: Epidural analgesia is the most effective method of pain relief during labour and the only method that provides complete analgesia without maternal or foetal adverse effects. This study aimed to assess the mode of delivery outcomes of labour in women who had received effective epidural analgesia. Methods: After ethical approval, this quasi-experimental study was carried out in Dhaka medical college hospital for one year, from July 2021 to June 2022. A total of 100 admitted pregnant women (37 weeks to 41 weeks) in the labour ward were included in the study according to the inclusion and exclusion criteria. Among them, 50 women were in group A (with epidural analgesia), and the other 50 were in group B (without epidural analgesia). A detailed history and thorough clinical examination were carried out on each patient. Data were collected in separate case-record forms and analyzed using SPSS 24. Results: Mean age, gestational age, parity, and body mass index were statistically similar in both group A and B. Normal vaginal delivery rate (86% vs. 90%), instrumental delivery rate (10% vs. 6%), and caesarean section rate (4% vs. 4%) were not significantly different in both groups. Besides, both group A and B had statistically similar APGAR scores at 1st (8.66±0.87 and 8.80±0.83 respectively, p=0.414) and 5th min (9.66±0.68 and 9.74±0.59 respectively, p=0.537). Conclusions: Epidural labour analgesia can be safely recommended as a method of labour analgesia, provided the prerequisites are fulfilled. It has no significant adverse effect on the mode of delivery.
评估硬膜外分娩镇痛对分娩方式的影响
背景:硬膜外镇痛是分娩过程中最有效的镇痛方法,也是唯一能提供完全镇痛且不会对母体或胎儿造成不良影响的方法。本研究旨在评估接受过有效硬膜外镇痛的产妇的分娩方式:在获得伦理批准后,这项准实验研究于 2021 年 7 月至 2022 年 6 月在达卡医学院附属医院进行,为期一年。根据纳入和排除标准,共有 100 名在产房住院的孕妇(37 周至 41 周)被纳入研究。其中,50 名产妇属于 A 组(使用硬膜外镇痛),另外 50 名产妇属于 B 组(不使用硬膜外镇痛)。对每位患者都进行了详细的病史询问和全面的临床检查。数据收集在不同的病例记录表中,并使用 SPSS 24 进行分析:A 组和 B 组的平均年龄、孕龄、胎次和体重指数在统计学上相似,两组的正常阴道分娩率(86% 对 90%)、器械助产率(10% 对 6%)和剖腹产率(4% 对 4%)无显著差异。此外,A组和B组在第1分钟(分别为8.66±0.87和8.80±0.83,P=0.414)和第5分钟(分别为9.66±0.68和9.74±0.59,P=0.537)的APGAR评分在统计学上相似:硬膜外分娩镇痛是一种安全的分娩镇痛方法。结论:只要满足前提条件,硬膜外分娩镇痛可被安全地推荐为分娩镇痛方法,对分娩方式无明显不良影响。
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