Progress of labor and obstetric outcome in parturients with combined spinal-epidural analgesia for labor: A comparative study.

Abstract

Background:Alleviation of labour pain is known to improve maternal and fetal outcome. Combined Spinal-Epidural (CSE) analgesia is an excellent method.Aim and objectives:In view of reports of its concerns on labour, this study was conducted to evaluate the progress of labour, obstetric outcome in cases with and without CSE analgesia, the maternal pain relief and fetomaternal adverse effects.Materials and methods:In this comparative study, 60 parturients were allocated into case and control groups of 30 each. CSE analgesia was administered utilizing 0.5 ml of 0.125% Levobupivacaine / 0.2% Ropivacaine with 2 mcg/ml fentanyl. Progress of labour was recorded in partogram including duration of labour, mode of delivery, pain relief - Visual Analogue Scale (VAS) score, development of motor block, maternal satisfaction and Apgar score. Data was analyzed by Descriptive and Inferential statistics.Results:Mean duration of first and second stage of labour among cases was 530±44.1 minutes, 61.5±12.7 minutes respectively and that of control was 526.6±64.9 minutes, 60±10.8 minutes respectively with no prolongation of labour P > 0.05. CSE analgesia did not alter the mode of delivery P=0.145 with rapid onset of pain relief. Apgar score was normal in both groups. Total 29 (97%) parturients experienced effective labour analgesia following CSE analgesia with VAS score 0. Maternal adverse effects included pruritus, transient initial motor blockade and post spinal headache.Conclusion:CSE analgesia did not affect the duration of labour, mode of delivery with minimal fetomaternal adverse effects and provides rapid onset of pain relief. CSE analgesia can be considered for safe and effective labour analgesia.