title: Requests and usage of epidural analgesia in grand-grand multiparous and similar-aged women with lesser parity: prospective observational study.
abstract: Epidural analgesia in older and multiparous women has been associated with risks. The aim of this study was to compare epidural analgesia use for labor/delivery in grand-grand multiparous women (GGMP; ≥10 births) relative to that in similar-aged women with lesser parity.
  
  
  
  This was a prospective observational study of advanced age gravida. All laboring women in a six-month period admitted to a tertiary Israeli center were included if they were advanced age (≥36 years old) with one to two previous births (Low parity; n=128) or four to five previous births (Medium parity; n=181), and all GGMP (any age; n=187). Primary outcome was comparison of requests for and use of epidural analgesia for labor/delivery.
  
  
  
  There were no significant differences across parity groups in percent of gravida requesting or receiving epidural analgesia (46.5-59.4%). Time from admission to epidural administration (range mean times: 168-187 min) and from advent of epidural to delivery (range mean times: 155-160 min) were comparable across parity groups. Use of other analgesia (5.8-8%) was not significantly different.
  
  
  
  Requests for and use of epidural analgesia was comparable in older gravida and was not correlated with parity. Mean times from presentation to epidural administration, mean cervical dilatation at epidural initiation, and mean time from performing of epidural to delivery were comparable across groups.
authors.affiliation: Department of Anesthesiology, ShaareZedek Medical Center, Jerusalem, Israel. aioscovich@gmail.com
authors.forename: Alexander
authors.initials: A
authors.lastname: Ioscovich
authors.forename: Angelika
authors.initials: A
authors.lastname: Fadeev
authors.forename: Alina
authors.initials: A
authors.lastname: Rivilis
authors.forename: Deborah
authors.initials: D
authors.lastname: Elstein
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000706:statistics & numerical data*; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007557:Israel; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors