title: A comprehensive analysis of continuous epidural analgesia's effect on labor and neonates in maternal hypertensive disorder patients.
abstract: BACKGROUND
  Maternal hypertensive disorder is one of the most common and severe medical complications during pregnancy. Epidural analgesia administration is widely used during labor process.
  
  
  OBJECTIVE
  To evaluate the potential advantage or disadvantage of continuous epidural analgesia's on labor and neonates for maternal hypertensive disorder patients comprehensively.
  
  
  METHODS
  We have retrospectively analyzed 232 patients who diagnosed as maternal hypertensive disorder in our hospital since 2015. Among which, 126 patients including 28 cases of severe preeclampsia were administrated with continuous epidural analgesia (Analgesia group), the other 106 patients were untreated (Control group). We have compared the maternal age, body weight, gestational weeks, period for the first and second labor stage; the incidence of eclampsia, natural labor, cesarean section, forceps delivery and postpartum hemorrhage between these two groups respectively; furthermore, we recorded patients who received oxytocin and antihypertensive treatment during the delivery progress as well as evaluated the neonate body weight, Apgar score and performed umbilical cord blood gas analysis.
  
  
  RESULTS
  Continuous epidural analgesia does not affect the first and second labor stage period (p=0.36), However, there is a significantly higher demand for oxytocin treatment (36.5% Vs 19.8%, p<0.01) and a significantly lower requirement for antihypertensive treatment (22.2% Vs 81.1%, p<0.001) in analgesia group compared to control group. We also notice that the natural delivery ratio in analgesia group is higher than control group and most importantly, continuous epidural analgesia can increase 1min Apgar score and has no other effect on neonates' body weight, umbilical cord blood gas parameters, 5min and 10min Apgar score.
  
  
  CONCLUSIONS
  Our result based on a large cohort comprehensive analysis indicates that continuous epidural analgesia can benefit both maternal hypertensive disorder patients and neonates without any side effect.
authors.affiliation: Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Han
authors.affiliation: Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China. Electronic address: snake_650222@126.com.
authors.forename: Mingjun
authors.initials: M
authors.lastname: Xu
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000379:methods; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001034:Apgar Score; D001724:Birth Weight; D001835:Body Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D004461:Eclampsia / Q000453:epidemiology; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000503:physiopathology*; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008423:Maternal Age; D009772:Obstetrical Forceps; D010121:Oxytocin / Q000008:administration & dosage; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy
chemical_list: D000959:Antihypertensive Agents; D010121:Oxytocin
keywords: Continuous epidural analgesia; Labor analgesia; Maternal hypertensive disorder; Neonate