The effects of the epidural analgesia on the progress of the labor and labor outcome at different degrees of cervical dilatation [Primipar olgularda degişik servikal açikliklarda uygulanan epidural analjezinin travay süresi ve dogum eylemi üzerine etkileri]

Abstract

Recently, different results have been reported that epidural analgesia prolongs labor, increases instrumental vaginal delivery and operative delivery. The purpose of the present study was to determine the effects of the epidural analgesia on the progress of labor and labor outcome at different degrees of cervical dilatation. After approval by the ethical committee, a total of 136 patients scheduled for vaginal delivery were divided into 2 groups. Each group divided into 3 subgroups according to the degree of cervical dilatation. In these subgroups; the degree of cervical dilatation was < 4 cm in group Ia and IIa, 4-5 cm in group Ib and IIb and >5 cm in group Ic and IIc. Epidural catheters were placed for analgesia in group I. Group II was not given any analgesic therapy during labor. Group I parturient received an epidural injection of 12.5 mg (0.125 %) bupivacaine + 50 µg fentanyl. Then they received 0.125 % bupivacaine with 2.5 µg ml-1 fentanyl via patient controlled analgesia (PCA). Patient controlled epidural analgesia (PCEA) background infusion was launched at a rate of 10 mL hour-1. Patients receiving PCEA were allowed to administer themselves a bolus dose of 5 mLevery 30 min as needed. Demographic data, number of pregnancy, degree of cervical dilatation, latent and active phases of the-labor (in the first and in the second stage), and duration of total stage of the labor was recorded. Additionally, systolic- diastolic blood pressure (SBP-DBP), fetal (FHR) and maternal (HR) heart rates and peripheral oxygen saturation (SpO2) were also assessed. However, duration of the first and total stage of the labor was found significantly shorter in epidural subgroups duration of latent phase of the labor was similar between two groups. (p < 0.05). Although duration of the second stage of the labor was found shorter in all epidural subgroups, it was statistically not significant. It was found that the incidence of instrumental vaginal delivery and frequency of Caesarean section was not significant between two groups. In conclusion; epidural analgesia applied at different cervical dilatations, shortened the duration of the first stage and total duration of the labor, but it did not change the duration of the second stage of the labor. Epidural analgesia did not cause an increase in the incidence of instrumental vaginal delivery and the frequency of Caesarean section