Epidural anesthesia during childbirth — retrospective analysis of maternal and neonatal results

Objectives: In Poland, in accordance with applicable regulations, every woman should have access to epidural anesthesia. The advantage of this type of analgesia is primarily analgesic effectiveness. The aim of the study is to identify variables related to epidural anesthesia and to verify the relationship between them and the occurrence of perinatal complications in the mother and the child.Material and methods: This was a single-center retrospective cohort study. Electronic documentation of patients of the Hospital of St. Sofia in Warsaw was used to create an anonymous retrospective database of all births in the years 2015–2020. 27,340 cases were qualified for the analysis.Results: The logistic regression model showed that the risk of episiotomy (OR = 5.539; CI = 5.169–5.935) increases more than fivefold and perineal laceration (OR = 2.190; CI= 2.036–2.356) increases twice in the case of epidural anesthesia application. There is also an increased risk of operative delivery (OR = 2.668; CI = 2.255–3.156), at the same time the risk of performing a cesarean section decreases more than fivefold (OR = 0.043; CI = 0.036–0.052).Conclusions: Epidural anesthesia affects the delivery mechanism leading to an increase in the number and intensity of additional medical procedures — episiotomy, perineal laceration, operative delivery. The rationale for the routine use of this method of anesthesia should be considered in the context of the implications for the woman’s reproductive health and research on the effectiveness of other methods of birth anesthesia should be conducted

Epidural analgesia: effect on labor duration and delivery mode — a single-center cohort study

Objectives: Parturients in labor experiencing severe pain may develop several complications, which could be avoided using various forms of labor analgesia. Researchers hold divergent opinions about the effect of epidural analgesia (EA) on labor duration and delivery mode. This paper aims to establish if EA affects the duration of the 1st and the 2nd phase of labor and the percentage of emergency Cesarean sections (CS) and instrumental delivery. Material and methods: The patients in this cohort study were recruited at St. Sophia’s Specialist Hospital in Warsaw, between 1/1/2020 and 6/1/2020. We used following inclusion criteria: patients aged 18–40 with singleton pregnancies and cephalic presentation of the fetus who gave live birth at a gestational age of 37–42 weeks to neonates with birthweight 2500–4250 g and received EA at the cervical dilation between three and six centimeters. The control group didn’t receive anesthesia. We excluded planned CS and vaginal births after CS. Data analysis was performed for all parturients and separately for multiparas and nulliparas. Results Out of 2550 deliveries, we included 1052 patients — 443 participants with EA and 609 in the control group. Patients with epidural analgesia experienced longer labor 415 vs 255 min (p < 0.01), longer 1st and 2nd stage (p < 0.01). They had a lower risk of emergency CS (OR = 0.56) (p < 0.01) but were more likely to have instrumental delivery. Conclusions: EA prolongs the first and the second stage of labor yet doesn’t affect neonatal outcomes. Moreover, the risk of emergency CS in nulliparas with EA is three times lower