title: The effect of epidural analgesia on labour, mode of delivery and neonatal outcome in nullipara of India, 2011-2014.
abstract: OBJECTIVE
  This study aimed to evaluate the effect of ropivacaine epidural analgesia on duration and outcome of labour in nulliparous parturients of India with parturient not receiving any analgesia.
  
  
  METHODS
  One hundred and twenty nulliparous parturient in established labour at full term with a singleton vertex presentation were assigned to the study. Parturients who request epidural analgesia were allocated in the epidural group (n=60), whereas those not enthusiastic to labour analgesia were allocated in the control group (n=60).
  
  
  METHODS
  Epidural analgesia was provided by a bolus injection of 10 ml of ropivacaine 0.2% and 50μg fentanyl and maintained by using a continuous infusion of ropivacaine 0.1% with fentanyl 2μl/ml at a 10ml/hour rate. The outcomes were duration of labour, incidence of cesarean sections and instrumental vaginal delivery and neonatal outcome.
  
  
  METHODS
  Statistical analysis was conducted using unpaired student t-test and chi-square test as required. All tests of significance were performed using two-tailed probability tests. Differences were considered significant when p-value was <0.05.
  
  
  RESULTS
  The two groups were comparable in terms of socio-demographic data. The mean duration of first stage of labour was shorter in epidural group (4.83 ± 1.59 h) compared with control group (5.48 ± 1.56 h) while the duration of second stage of labour was prolong in epidural group (33.13 ± 12.78 min) as compared to control (27.53 ± 11.73 min). Instrumental vaginal or caesarean delivery rate did not increase in the epidural group. The APGAR scores at 5 min were statistically similar in both groups.
  
  
  CONCLUSIONS
  Epidural analgesia by ropivacaine in Indian nulliparous resulted in shorter duration of first stage and prolongs duration of second stage of labour compared with parturients without analgesia; however, instrumental vaginal or caesarean delivery rate does not increase in the epidural group.
authors.affiliation: Resident, Department of Obstetrics and Gynaecology, Batra Hospital and Medical Research Centre , Tughlakabad Institutional Area, New Delhi, India .
authors.forename: Dipti
authors.initials: D
authors.lastname: Agrawal
authors.affiliation: Senior Consultant, Department of Obstetrics and Gynaecology, Batra Hospital and Medical Research Centre , Tughlakabad Institutional Area, New Delhi, India .
authors.forename: Bela
authors.initials: B
authors.lastname: Makhija
authors.affiliation: Senior Consultant, Department of Obstetrics and Gynaecology, Batra Hospital and Medical Research Centre , Tughlakabad Institutional Area, New Delhi, India .
authors.forename: Manjeet
authors.initials: M
authors.lastname: Arora
authors.affiliation: Consultant, Department of Obstetrics and Gynaecology, Batra Hospital and Medical Research Centre , Tughlakabad Institutional Area, New Delhi, India .
authors.forename: Arpana
authors.initials: A
authors.lastname: Haritwal
authors.affiliation: Head of Department, Department of Anaesthesia & Critical Care, Batra Hospital and Medical Research Centre , Tughlakabad Institutional Area, New Delhi, India .
authors.forename: Pavan
authors.initials: P
authors.lastname: Gurha
keywords: Epidural analgesia; Labour; Nulliparous; Parturient; Ropivacaine