title: Does epidural analgesia affect the rate of spontaneous obstetric lacerations in normal births?
abstract: The precise relationship between epidural use and genital tract lacerations in normal childbirth is unclear. Data from a clinical trial on measures to lower genital tract trauma in vaginal birth were used for a secondary analysis. The goal was to assess whether epidurals affect the rate of spontaneous obstetric lacerations in normal vaginal births. Maternal characteristics and intrapartum variables were compared in women who did and did not use an epidural in labor, and also in those with and without any sutured lacerations following vaginal birth. Variables that were statistically different in both cases were entered into regression equations for simultaneous adjustment. Epidural use was not an independent predictor of sutured lacerations. Predictors of sutured lacerations included nulliparity, a prolonged second stage, being non-Hispanic white, and an infant birthweight greater than 4000 grams. Elements of midwifery management need further research.
authors.affiliation: University of New Mexico College of Nursing, Nursing/Pharmacy Building, Room 216, Albuquerque, NM 87131-5688, USA. lalbers@salud.unm.edu
authors.forename: Leah L
authors.initials: LL
authors.lastname: Albers
authors.forename: Laura
authors.initials: L
authors.lastname: Migliaccio
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Bedrick
authors.forename: Dusty
authors.initials: D
authors.lastname: Teaf
authors.forename: Patricia
authors.initials: P
authors.lastname: Peralta
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000451:nursing / Q000706:statistics & numerical data; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000451:nursing / Q000706:statistics & numerical data; D005260:Female; D005836:Genitalia, Female / Q000293:injuries; D006801:Humans; D007231:Infant, Newborn; D007748:Labor Stage, Second; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology* / Q000451:nursing; D009321:Natural Childbirth / Q000379:methods* / Q000451:nursing / Q000706:statistics & numerical data; D009516:New Mexico / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000451:nursing* / Q000517:prevention & control; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic