title: Epidural anesthesia in early compared with advanced labor.
abstract: OBJECTIVE
  To examine whether continuous lumbar epidural analgesia administered in the early phase of labor leads to an increased incidence of instrumental vaginal deliveries.
  
  
  METHODS
  In a retrospective analysis we have studied 563 consecutive term cephalic vaginal deliveries where an epidural was given for pain relief in labor. The type of delivery was compared in two groups. In Group 1 epidurals were given when the cervix was 3 cm or less dilated; in Group 2 when they were greater than 3 cm dilated.
  
  
  RESULTS
  There was no difference in the incidence of instrumental deliveries in the two groups. Other variables including station of the fetal head, premature rupture of membranes, meconium, and administration of pitocin and pethidine did not effect these results.
  
  
  CONCLUSIONS
  There is no justification in delaying epidural analgesia in labor when it is clinically indicated.
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah University Hospital, Ein Karem, Jerusalem, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Ohel
authors.forename: H
authors.initials: H
authors.lastname: Harats
mesh_terms: D000767:Anesthesia, Epidural; D005113:Extraction, Obstetrical; D005260:Female; D006801:Humans; D007747:Labor Stage, First; D011247:Pregnancy; D012189:Retrospective Studies