Assessment of the effects of epidural labour analgesia on the second stage of labour

Marufa Khatun; Sharmina Siddique; Rawshan Ara Sultana; Dilruba Yasmin; Tamanna Rahman; Asma Akter

doi:10.18203/2320-1770.ijrcog20243920

Authors

Marufa Khatun Upazila Health Complex, Mithapukur, Rangpur, Bangladesh
Sharmina Siddique Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh
Rawshan Ara Sultana Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh
Dilruba Yasmin Department of Obstetrics and Gynecology, District Sadar Hospital, Sherpur, Bangladesh
Tamanna Rahman Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh
Asma Akter Dhaka Medical College Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20243920

Keywords:

Epidural labour analgesia, Second stage of labour, APGAR score

Abstract

Background: The second stage of labour is very important when the actual delivery of the baby takes place. This study aimed to evaluate the effects of epidural labour analgesia on the second stage of labour.

Methods: This quasi-experimental study was carried out in Dhaka Medical College Hospital, for one-year period from July 2021 to June 2022 after ethical approval. A total of 100 admitted pregnant women (37 weeks to 41 weeks) in 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 another 50 women were in group B (without epidural analgesia). A detailed history and thorough clinical examination were carried out in each patient. Data were collected in separate case-record form and analyzed by SPSS 24.

Results: Mean age, gestational age, parity were statistically similar in both Group A and Group B. Duration of second stage of labour (52.18±37.72 versus 46.2±31.42 minutes, p=0.499) in nulliparous and (34.65±21.17 versus 29.2±14.72 minutes, p=0.364) in multiparous women was comparable in the two groups. Besides, both Group A and Group B had statistically similar APGAR score at 1^st (8.66±0.87 and 8.80±0.83 respectively, p=0.414) and 5^th minute (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 pain relief during labour, provided the necessary conditions are met. It does not have a significant adverse effect on the duration of the second stage of labour.

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References

Deshmukh VL, Ghosh SS, Yelikar KA, Gadappa SN. Effects of epidural labour analgesia in mother and foetus. J Obstet Gynecol India. 2018;68(2):111-6.

Lam KK, Leung MK, Irwin MG. Labour analgesia: update and literature review. Hong Kong Med J. 2020;26(5):413.

Sahu RR, Shivgan SM. To study the effect of epidural analgesia on second stage of labour and mode of delivery. Indian J Obstet Gynecol Res. 2018;5(4):553-8.

Srebnik N, Barkan O, Rottenstreich M, Ioscovich A, Farkash R, Rotshenker-Olshinka K, et al. The impact of epidural analgesia on the mode of delivery in nulliparous women that attain the second stage of labor. J Matern Fet Neonat Med. 2020;33(14):2451-8.

Munro A, George RB, Allen VM. The impact of analgesic intervention during the second stage of labour: a retrospective cohort study. Canadian J Anesth. 2018;65(11):1240-7.

Lee L, Dy J, Azzam H. Management of spontaneous labour at term in healthy women. J Obstet Gynaecol Canada. 2016;38(9):843-65.

Penuela I, Isasi-Nebreda P, Almeida H, López M, Gomez-Sanchez E, Tamayo E. Epidural analgesia and its implications in the maternal health in a low parity comunity. BMC Pregnancy Childbirth. 2019;19:1-9.

Shmueli A, Salman L, Orbach‐Zinger S, Aviram A, Hiersch L, Chen R, et al. The impact of epidural analgesia on the duration of the second stage of labor. Birth. 2018;45(4):377-84.

Rimaitis K, Klimenko O, Rimaitis M, Morkunaite A, Macas A. Labour epidural analgesia and the incidence of instrumental assisted delivery. Medicina. 2015;51(2):76-80.

Deepak D, Kumari A, Mohanty R, Prakash J, Kumar T, Priye S. Effects of epidural analgesia on labour pain and course of labour in primigravid parturients: a prospective non-randomized comparative study. Cureus. 2022;14(6):1-8.

Papalkar J, Shrivastava D, Hariharan C. Epidural analgesia in labour. Int J Biol Med Res. 2013;4(1):2707-12.

Naito Y, Ida M, Yamamoto R, Tachibana K, Kinouchi K. The effect of labor epidural analgesia on labor, delivery, and neonatal outcomes: a propensity score-matched analysis in a single Japanese institute. JA Clin Rep. 2019;5:1-7.

Indraccolo U, Ripanelli A, Di Iorio R, Indraccolo SR. Effect of epidural analgesia on labour times and mode of delivery: A prospective study. Clin Exp Obstet Gynecol. 2012;39(3):310-3.

Cheng YW, Hopkins LM, Caughey AB. How long is too long: Does a prolonged second stage of labour in nulliparous women affect maternal and neonatal outcomes? Am J Obstet Gynecol. 2004;191(3):933-8.

Traynor AJ, Aragon M, Ghosh D, Choi RS, Dingmann C, Tran ZV, et al. Obstetric anesthesia workforce survey: a 30-year update. Anesth Analg. 2016;122(6):1939-46.

Anim‐Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non‐epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018(5):1.