Epidural analgesia and instrumental delivery.
In patients given epidural analgesia who had singleton vertex vaginal deliveries the normal delivery rate was 57%, compared to 80% in all this group. The increase in instrumental delivery rate could partly be accounted for by parity (primigravidae are over-represented in the epidural group), by obstetric and medical indications for epidurals, and by the need for sitting top-ups to relieve perineal pain. There remained a small population of patients in whom epidurals may have contributed to the need for instrumental delivery.
D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage; D036861:Delivery, Obstetric; D004334:Drug Administration Schedule; D005113:Extraction, Obstetrical; D005260:Female; D006801:Humans; D009772:Obstetrical Forceps; D010298:Parity; D011247:Pregnancy
D002045:Bupivacaine