Observational Analysis: A Prospective Study of the Correlation Between the State of the Maternal Spine and the Progress of Labor Under Epidural Analgesia

Background: People have always believed that going through the process of childbirth is a gift, although pain experienced during labor by a woman occupies the second level in the pain score table. But that belief that one has to undergo pain during labor is slowly fading away, as we are entering an era where women are seeking options for painless labor, and delivery. Objective: To evaluate the spine of women in labor opting for epidural analgesia. To correlate the abnormal position of the maternal spine to the progress of labor and outcomes. Methods: The current prospective observational study performed between 2021-2023 had enrolled 200 women who were given epidural analgesia irrespective of stage of labor. Women who had a history of spine surgeries or congenital spinal deformities were excluded. Results: Of the 200 women included in the study, 80 women showed a deviation of spine mostly to the right from the midline or significant lordosis, irrespective of babies’ weight and maternal height. Out of the 80 women, 70 women ended up in an emergency cesarean section. Of the 70 women who were taken up for emergency c-sections, the major indication was nonprogress of the second stage of labor. Ten patients had a vaginal delivery, of which 3 had assisted instrumental delivery due to a prolonged second stage and poor maternal efforts. Conclusion: Irrespective of maternal height, weight of the baby, and stages of labor, if the spine shows lordosis with significant deviation from the midline most commonly towards the right it can have a significant impact on the progress of labor and outcomes.