title: Update on some aspects of the use of epidural analgesia in labour.
abstract: The aim of the study was to investigate the effect of epidural analgesia on blood pressure, duration of the second stage and mode of delivery. In a prospective controlled study carried out in a district general hospital, 122 parturients made up the study population; 81 had epidural blocks and 41 had other forms of analgesia during labour. Data were collated using questionnaires within 48 hours of delivery: 58/81 (71.6%) of those who chose epidural were primigravidae compared with 14/41 (34%) in the non-epidural group (p < 0.001). During labour, minimum diastolic blood pressure was significantly lower in the epidural group: 65.8 versus 72.4 mmHg (p = 0.003). Mean duration of the second stage of labour was significantly longer in the epidural group: 108.3 versus 41.6 minutes (p < 0.0001); 28/81 (34.6%) of the epidural group had operative vaginal deliveries compared with 6/41 (14.6%) of the non-epidural group (p = 0.0004). Epidural analgesia provides an effective form of pain relief in labour, which has a particularly strong appeal to primigravidae. It has a hypotensive effect which can be put to beneficial effect in hypertensive disease of pregnancy, but is significantly associated with a lengthened second stage of labour, resulting in an increased operative vaginal delivery rate.
authors.affiliation: Women's Centre, John Radcliffe Hospital, Oxford, UK.
authors.forename: P
authors.initials: P
authors.lastname: Okojie
authors.forename: P
authors.initials: P
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007748:Labor Stage, Second / Q000187:drug effects; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D004561:Transcutaneous Electric Nerve Stimulation