Effect of epidural analgesia on duration and outcome of induced labor.
OBJECTIVE
To evaluate the effect of epidural block on the duration of labor and maternal and fetal outcome in induced-labor patients.


METHODS
210 women admitted for induction of labor at a level III university hospital, during the year 1991, were studied. Of these, 112 were given an epidural block and 98 served as controls. Outcome measures studied were: induction time and time in labor, c-section and instrumental delivery rates, intra-partum and post-partum complications, and Apgar scores at 1 and 5 min.


RESULTS
Multiple regression analysis revealed that epidural analgesia, before and after adjustment for confounding factors, significantly prolonged labor time (P < 0.0001) and was associated with an increase in instrumental delivery rates (P < 0.04). A significant reduction in intra-partum complication rate (FHR changes, meconium) was observed (OR = 0.32; P < 0.03), while c-section rate and Apgar scores were not found to be influenced by epidural analgesia.


CONCLUSIONS
Epidural anesthesia, significantly prolongs labor time in induced patients. While instrumental delivery was more prevalent in these parturients, c-section rate was not increased and intra-partum complications were significantly reduced in these patients.
Rojansky
N
N
Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem, Israel. Rojan@cc.huji.il
Tanos
V
V
Reubinoff
B
B
Shapira
S
S
Weinstein
D
D
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D001034:Apgar Score; D002045:Bupivacaine / Q000009:adverse effects*; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D007744:Obstetric Labor Complications / Q000139:chemically induced*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D002045:Bupivacaine